scholarly journals ISSUES OF MEDICAL CARE FOR LOWER JAW FRACTURES IN OLDER PERSONS

2019 ◽  
Vol 23 (3-4) ◽  
pp. 165-172
Author(s):  
Alexander S. Pankratov ◽  
A. V Karalkin ◽  
Z. P Gotsiridze
Keyword(s):  
Medical Care ◽  
Clinical Features ◽  
Older Patients ◽  
Older Persons ◽  
Randomized Clinical Trials ◽  
General Structure ◽  
Mandibular Fractures ◽  
Facial Skeleton ◽  
Significant Group ◽  
Lower Jaw

At present, there is an increase in the number and proportion of older persons. Accordingly, the requirements to ensure the necessary quality of life of this category of population are increasing. This applies, inter alia, to the issues of their rehabilitation after various diseases and injuries. Among the injuries of the bones of the facial skeleton, the most common type are fractures of the lower jaw. The purpose of this work is to analyze the prevalence, clinical features of mandibular fractures in patients of the older age group and the effectiveness of existing methods of their treatment, according to modern literature data. RSCI, PubMed, Medline databases for the period 1960 - 2019 were used to compile the review. Results. Data from 687 literary sources were used in the preparation of this review. Their analysis shows that older patients represent a stable and statistically significant group, in the General structure of victims with mandibular fractures, and having a number of clinical features, as a result of which conventional methods of treatment are often ineffective. The most common concepts of medical care for this category of patients are characterized. Conclusion. To date, there are no reliable randomized clinical trials based on sufficient statistically material that allows to substantiate the advantages of a particular method of treatment of older patients with mandibular fractures at the evidence level, which requires the continuation of the relevant multicenter clinical studies.

scholarly journals FACTORS INFLUENCING THE CLINICAL COURSE OF LOWER JAW FRACTURES AND DURATION OF TEMPORARY DISABILITY

2021 ◽  
Vol 17 (2) ◽  
pp. 103-109
Author(s):  
Faniya Mirsaeva ◽  
Timur Hanov
Keyword(s):  
Chronic Infection ◽  
Clinical Course ◽  
Poor Quality ◽  
Mandibular Fractures ◽  
Facial Skeleton ◽  
Multiple Fractures ◽  
Lower Jaw ◽  
Factors Influencing ◽  
Jaw Fractures

Thing. Among the fractures of the bones of the facial skeleton are most often re-breaking down the lower jaws. The diagnosis of them does not represent difficulties, but despite this, the clinical course of the lower jaw fractures is often complicated by the development of herbal osteomyelitis, which affects the reparative processes in the bone and for the duration of the temporary disability of patients. In connection with the foregoing, the study of factors af-fecting the clinical course of the lower jaw fractures, and the investigator, but on the duration of the temporary disability of patients, is relevant. Purpose — to study the factors influencing the clinical course of mandibular fractures and the timing of temporary disability of patients Methodology. An analysis of 918 stories of the disease of patients with fractures of the Low-er Chelf. The share of traumatic osteomyelitis is determined. Possible factors that contribute to the development of this complication and an increase in the duration of temporary disability is studied. Results. The development of traumatic osteomyelitis in the fractures of the lower jaw is due to the complex of interrelated factors. The most significant among them are: non-timely appeal of the victims of specialized help, senior wagon, poor-quality assistance in the pre-hospital stage, the presence of a stroke of Zu-Ba, having a chronic infection in the periapical tissues and the incorrect tactics of the doctor in relation to this tooth, Multiple fractures on one side of the chemistry, the choice of the method of fixing fragments. The duration of the temporary disability of patients with the development of traumatic osteomyelitis is significantly larger than with the uncomplicated clinical course of the lower jaw fractures. Conclusions. In order to reduce the frequency of development of traumatic osteomyelitis, it is necessary to conduct targeted prophylactic work aimed at improving the quality of the provi-sion of specialized assistance to patients with fractures of the lower person, both in the dogoital and hospital stages.

scholarly journals Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Critically Ill ◽  
Clinical Features ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Severe Infection ◽  
Factors Affecting ◽  
Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

scholarly journals A probability model for evaluating the bias and precision of influenza vaccine effectiveness estimates from case-control studies

2014 ◽  
Vol 143 (7) ◽  
pp. 1417-1426 ◽  
Author(s):  
M. HABER ◽  
Q. AN ◽  
I. M. FOPPA ◽  
D. K. SHAY ◽  
J. M. FERDINANDS ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Medical Care ◽  
Randomized Clinical Trials ◽  
Probability Model ◽  
Control Design ◽  
Case Control ◽  
Vaccine Effectiveness ◽  
Case Control Studies ◽  
Respiratory Illnesses ◽  
Study Designs

SUMMARYAs influenza vaccination is now widely recommended, randomized clinical trials are no longer ethical in many populations. Therefore, observational studies on patients seeking medical care for acute respiratory illnesses (ARIs) are a popular option for estimating influenza vaccine effectiveness (VE). We developed a probability model for evaluating and comparing bias and precision of estimates of VE against symptomatic influenza from two commonly used case-control study designs: the test-negative design and the traditional case-control design. We show that when vaccination does not affect the probability of developing non-influenza ARI then VE estimates from test-negative design studies are unbiased even if vaccinees and non-vaccinees have different probabilities of seeking medical care against ARI, as long as the ratio of these probabilities is the same for illnesses resulting from influenza and non-influenza infections. Our numerical results suggest that in general, estimates from the test-negative design have smaller bias compared to estimates from the traditional case-control design as long as the probability of non-influenza ARI is similar among vaccinated and unvaccinated individuals. We did not find consistent differences between the standard errors of the estimates from the two study designs.

scholarly journals Development and validation of a delirium risk assessment tool in older patients admitted to the Emergency Department Observation Unit

2021 ◽  
Author(s):  
A. Zucchelli ◽  
R. Apuzzo ◽  
C. Paolillo ◽  
V. Prestipino ◽  
S. De Bianchi ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Emergency Department ◽  
Older Patients ◽  
Older Persons ◽  
Assessment Tool ◽  
Training Sample ◽  
Risk Assessment Tool ◽  
Observation Unit ◽  
Old Patients ◽  
Two Samples

Abstract Background Delirium is frequent though undetected in older patients admitted to the Emergency Department (ED). Aims To develop and validate a delirium risk assessment tool for older persons admitted to the ED Observation Unit (OU). Methods We used data from two samples of 65 + year-old patients, one admitted to the ED of Brescia Hospital (n = 257) and one to the ED of Desio Hospital (n = 107), Italy. Data from Brescia were used as training sample, those collected in Desio as testing one. Delirium was assessed using the 4AT and patients’ characteristic were retrieved from medical charts. Variables found to be associated with delirium in the training sample were tested for the creation of a delirium risk assessment tool. The resulting tool’s performances were assessed in the testing subsample. Results Of all possible scores tested, the combination with the highest discriminative ability in the training sample included: age ≥ 75 years, dementia diagnosis, chronic use of neuroleptics, and hearing impairment. The delirium score exhibited an AUC of 0.874 and 0.893 in the training and testing samples, respectively. For a 1-point increase in the score, the odds of delirium increased more than twice in both samples. Discussion We propose a delirium risk assessing tool that includes variables that can be easily collected at ED admission and that can be calculated rapidly. Conclusion A risk assessment tool could help improving delirium detection in older persons referring to ED.

Ethical Issues of Emergency Medical Care for Older Patients

2017 ◽  
pp. 369-395
Author(s):  
Helen Askitopoulou ◽  
Katrin Singler ◽  
Thomas Frühwald ◽  
Monique Weissenberger-Leduc
Keyword(s):  
Medical Care ◽  
Older Patients ◽  
Ethical Issues ◽  
Emergency Medical Care ◽  
Emergency Medical

scholarly journals Structural composition and clinical features of dermatological patients with keratinocytic skin tumors

2021 ◽  
Vol 67 (1) ◽  
pp. 91-96
Author(s):  
Rustem Khasanov ◽  
Elena Faizullina ◽  
Irina Khismatulina ◽  
Azat Murtazin
Keyword(s):  
Skin Cancer ◽  
Medical Care ◽  
Clinical Features ◽  
Basal Cell ◽  
Clinical Manifestations ◽  
Pathological Process ◽  
Skin Tumors ◽  
Long Period ◽  
Nasal Region ◽  
Common Malignancy

Basal cell skin cancer (BCС) is the most common malignancy that is found in dermatological practice. The purpose of the study: to determine the structure of clinical manifestations of BCС in ambulant dermatological patients. The study was conducted from 2015 to 2017 in a private clinic in Kazan, which has a license to provide medical care in the specialties "dermatovenerology" and "surgery". We studied the results of examination of 2730 patients with skin tumors available in outpatient cards. 101 patients with histologically verified BCС were examined, including 29% of men (n=29) and 71% of women (n=72), the average age was 59.7±14.9 years (median – 61.5 years). The percentage of patients with BCС among patients with all skin malignancies at the dermatological reception was 95.3% (n=101). Most often, patients aged 60-74 years suffered from BCС: women – in 21.0% (n=21) and men – in 16.0% (n=16), respectively. The proportion of women aged 45-59 years was significantly higher – 20.0%, than the proportion of men – 9.0% (p<0.05). Men were significantly more likely to see a dermatologist – 55.0% in less than a year from the onset of the disease, than women – 21.4% (p<0.01). The proportion of women (44.6%) who noted the appearance of a tumor over a long period (≥5 years) was significantly less than the proportion of men 15.0% (p<0.05). The most common variant of BCС was the nodular form n=77 (76.2%), in which the primary elements of 80.5% were identified by dermatologists as single 5-10 mm papules. The oculo-fronto-nasal region was involved in the pathological process in 47.5% (n=48) of cases, which is significantly more frequent than in other localisations (p<0.05). Dermatoscopy improved the visualization of the atypical vascular network.

THE MEDICAL CARE OF AUTISTIC CHILDREN

PEDIATRICS ◽  
1973 ◽  
Vol 51 (2) ◽  
pp. 278-280
Author(s):  
Donald J. Cohen
Keyword(s):  
Natural History ◽  
Medical Care ◽  
Clinical Features ◽  
Developmental Disability ◽  
Behavioral Control ◽  
Children With Autism ◽  
First Year ◽  
Social Emotional ◽  
Psychiatric Disturbance ◽  
Psychiatric Disturbances

Childhood autism is the most overwhelming psychiatric disturbance of childhood. Announcing its presence during the first year or two of life, its natural history is often a profound, life-long developmental disability affecting every sphere of social, emotional, and intellectual functioning. Kanner's1 classic description of children who have difficulty in relating to people and things from the beginning of life has been followed by an abundance of studies expanding our knowledge of the clinical features of autism. Children with autism have been found to present a variety of disturbances in language, perception, neurophysiological organization, and emotional and behavioral control.2-5 Unfortunately, epidemiologic, genetic, and metabolic investigations are limited, as they are for all serious psychiatric disturbances in childhood.

Clinical features and outcome of difficult-to-treat infections in a high-intensity medical care ward

2020 ◽  
Author(s):  
Alessandro RUSSO ◽  
Federica MARINCOLA CATTANEO ◽  
Grazia BRUNETTI ◽  
Alice PICCIARELLA ◽  
Roberta RUSSO ◽  
...  
Keyword(s):  
Medical Care ◽  
Clinical Features ◽  
High Intensity ◽  
Care Ward

The skull

2013 ◽  
Author(s):  
Martin E. Atkinson
Keyword(s):  
Soft Tissues ◽  
Clinical Importance ◽  
Dental Students ◽  
Structural Basis ◽  
Facial Skeleton ◽  
Lower Jaw ◽  
Temporomandibular Joints ◽  
Maxilla And Mandible ◽  
And Function ◽  
The Brain

Dental students and practitioners require a sound knowledge of the structure, growth, and development of the skull as a whole. The structure of the skull can be examined and studied more efficiently if you have access to a dried skull or one of the very good plastic replica skulls which are now available; you can identify the structures on the diagrams accompanying the following descriptions and examine a skull at the same time to appreciate the size and relationships of individual components. This chapter outlines the basic principles of the development and structure of the skull and includes some reference to individual bones where this makes understanding easier. The more detailed aspects of particular regions of the skull will be covered in the appropriate chapter describing the whole anatomy of that region; it is much easier to learn the parts of the skull in context of overall structure and function rather than learning a long list of bones, foramina, and muscle attachments in isolation from the related soft tissue structures. Only the maxilla and mandible which are bones of significant clinical importance are described as separate bones. As already demonstrated in Chapter 20, the skull is the structural basis f or the anatomy of the head. The skull has many functions. • It encloses and protects the brain. • It provides protective capsules for the eyes and middle and inner ear. • It forms the skeleton of the entrances to the respiratory and gastrointestinal tracts (GIT) through the nose and mouth, respectively. Those skull components that form the entrance to the GIT also house and support the teeth and soft tissues of the oral region as part of this function. As already outlined in Chapter 20, the skull is made up of several bones joined together to form the cranium which articulates with the separate mandible forming the lower jaw at the temporomandibular joints. The cranium specifically refers to the skull without the mandible; the terms ‘skull’ and ‘cranium’ are not strictly synonymous but they are frequently used as though they are. The cranium can be subdivided into the braincase enclosing the brain and the facial skeleton.

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