scholarly journals FEATURES OF REGIONAL ANESTHESIA AND POSSIBLE COMPLICATIONS IN OPHTHALMIC SURGERY

2018 ◽  
Vol 12 (3) ◽  
pp. 138-147
Author(s):  
Victoria V. Myasnikova ◽  
S. N Sahnov ◽  
A. O Martsinkevich ◽  
M. V Golovataya
Keyword(s):  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Local Anesthetics ◽  
The Elderly ◽  
Age Group ◽  
Ophthalmic Surgery ◽  
Retrobulbar Anesthesia ◽  
Peribulbar Anesthesia ◽  
Chronic Somatic Diseases ◽  
Somatic Diseases

In ophthalmic surgery, the choice of the method of anesthesia presents certain difficulties for both the anesthesiologist and the ophthalmologist. According to world statistics, the most frequently performed ophthalmic operations are performed in patients of the older age group who have concomitant chronic somatic diseases (diabetes mellitus, hypertension, atherosclerosis, etc.). It is advisable to use local anesthesia in the elderly, as well as in patients with severe co-morbidities or contraindications to general anesthesia. The review presents the characteristics of local anesthetics and the types of local anesthesia used in ophthalmic surgery (vesicular blockade, facial nerve blockade, retrobulbar anesthesia, peribulbar anesthesia, instillation or topical anesthesia). Also in the article, possible complications of these methods of regional anesthesia, their prevention and the principles of emergency care in case of their occurrence are described. Particular attention in the review is given to the toxicity of local anesthetics.

Risk of Suicidal Behaviours in Elderly

2017 ◽  
Vol 41 (S1) ◽  
pp. S652-S652 ◽  
Author(s):  
S. Goretti ◽  
M.D.C. Sanchéz Sanchéz ◽  
B. Góngora Oliver ◽  
M.D. Sanz Fernández
Keyword(s):  
Risk Factors ◽  
Suicidal Behaviour ◽  
The Elderly ◽  
Progressive Increase ◽  
Age Group ◽  
Somatic Illness ◽  
History Of ◽  
Competing Interest ◽  
Chronic Somatic Diseases ◽  
Somatic Diseases

IntroductionOlder adults constitute the age group in which suicide more often reaches its most categorical expression: consummation.ObjectiveIdentify risk factors for suicide in older people.MethodSystematic review of the literature on the subject. The databases consulted were Dialnet and Pubmed. The descriptors used have been: “suicide”, “risk factors” and “elderly”, accepting the works found in English and Spanish, with a total of 501 references found after the search, from which 75 have been selected.ResultsAs shown in the reviewed studies, there is a progressive increase in suicide rate with age in males. The purpose of dying in the old man is usually characterized by his firm conviction, not infrequently reflexive and premeditated. In the multifactorial etiology of suicidal behaviour in this age group, the main elements to be considered would be psychosocial factors, psychiatric diseases and chronic somatic diseases, resulting in a potentiation among them due to their frequent interaction. The feeling of abandonment, the feeling of emptiness, the despair of the organic collapse and the self-perception of being a useless person, without projects, generates deterioration in the quality of life.ConclusionsIn the multifactorial etiology of the suicidal behaviour of the elderly, they usually play coprotagonic roles, loneliness, isolation, somatic illness and depression. The most likely profile of the suicidal elder would be represented by a man with a history of depressive episode after age 40, who lives alone, with a family history of depression or alcoholism and a recent loss.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Clinical features of affective disorders in the elderly

2011 ◽  
Vol 26 (S2) ◽  
pp. 855-855 ◽  
Author(s):  
N.M. Popova ◽  
N.I. Shakhurova ◽  
E.D. Schastnyy
Keyword(s):  
Affective Disorders ◽  
Depressive Disorders ◽  
Clinical Symptoms ◽  
Clinical Problem ◽  
The Elderly ◽  
Co Morbidity ◽  
Somatic Disorders ◽  
Chronic Somatic Diseases ◽  
High Level ◽  
Somatic Diseases

IntroductionMood disorders in the elderly are a relevant clinical problem associated with high prevalence and frequent co-morbidity with chronic somatic diseases.ObjectiveStudy of clinical traits of depression in elder persons with somatic disorders.MethodsThe investigation was entered by 582 persons (women = 391 (67,1%), men = 191 (32,9%)), mean age of women has constituted 67,5 ± 5,8 years, men - 62,1 ± 3,8 years.Criteria of inclusionAge in women 55 years and higher, in men - 60 years and higher, clinical level of depression according to Beck Inventory more than 22 scores.ResultsAffective disorders were represented by symptom complexes that masked depression and complicated diagnosis. Clinical symptoms in the kind of anhedonia and complaints about anergia dominated (73,6%), whereas depression, melancholy have moved behind and have constituted 26,4%. Psychopathologic disturbances presented against the background of lingering chronically flowing neurological and somatic diseases (cerebral atherosclerosis, brain blood circulation impairment, IHD, HI, respiratory organs’ diseases) in 73,6 %. High risk of emergence of depressive disorders was noticed in widows with low level of education, living in rural area and in persons with somatic diseases. In 32% of probands we have revealed depression that correlated with marital status and feeling of loneliness (p > 0,005). In persons with high level of depression and experiencing feeling of loneliness, risk of suicidal behavioral was higher 2,1 as much.ConclusionsStudy of affective disorders in the elderly allows assessing co-morbidity of somatic and mental disorders, developing tactic of psychotherapeutic and psychopharmacological assistance rendering.

Peribulbar versus  Retrobulbar Anesthesia for Ophthalmic Surgery

2001 ◽  
Vol 94 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Jacques Ripart ◽  
Jean-Yves Lefrant ◽  
Jean-Emmanuel de La Coussaye ◽  
Dominique Prat-Pradal ◽  
Bruno Vivien ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Local Anesthetic ◽  
Clinical Studies ◽  
The Other ◽  
Ophthalmic Surgery ◽  
Retrobulbar Anesthesia ◽  
Thin Slices ◽  
Human Cadavers ◽  
Peribulbar Anesthesia

Background Peribulbar and retrobulbar anesthesia have long been opposed on the basis of the existence of an intermuscular membrane, which is supposed to separate the intraconal from the extraconal spaces in a water-tight fashion. A local anesthetic injected outside the cone should spread through this septum to reach the nerves to be blocked. The existence of this septum is questioned. The aim of this study was to compare the spread of a colored latex dye injected intraconally or extraconally to simulate both retrobulbar and peribulbar anesthesia. Methods The authors used 10 heads from human cadavers. For each head, one eye was injected intraconally, and the other eye was injected extraconally. The heads were then frozen and sectioned into thin slices following various planes. They were then photographed and observed. Results There was no evidence of the existence of an intermuscular septum separating the intraconal and extraconal spaces. Those two spaces appeared to be part of a common spreading space, the corpus adiposum of the orbit. Conclusions These results are in accord with the fact that clinical studies were not able to clearly demonstrate that retrobulbar anesthesia is more efficient than peribulbar anesthesia. On the basis of a similar clinical efficacy of the two techniques as a result of similar spreading of the local anesthetic injected, and a potentially higher risk of introducing the needle into the muscular cone, the authors recommend replacing retrobulbar anesthesia with peribulbar anesthesia.

Local Anesthetics – Substances with Multiple Application in Medicine

2016 ◽  
Vol 4 (1) ◽  
pp. 17
Author(s):  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Cezar Laurențiu Tomescu ◽  
Cristina Luiza Erimia ◽  
Stelian Paris ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Medical Care ◽  
Local Anesthesia ◽  
Short Duration ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Nerve Roots ◽  
Nervous Control ◽  
Painful Sensation ◽  
Action Groups

Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.

scholarly journals Nutrition Study People over 80 Years

2012 ◽  
Vol 2 (3) ◽  
pp. 77-89
Author(s):  
Javier Benítez ◽  
Nieves Perejón ◽  
Marcelino Arriaza ◽  
Pilar Bellanco
Keyword(s):  
Quality Of Life ◽  
The Elderly ◽  
Blood Chemistry ◽  
Living Alone ◽  
Age Group ◽  
Nutrition Study ◽  
Geriatric Evaluation ◽  
The Mean ◽  
Elderly Living

Loneliness has always been associated and reported as a risk factor of malnutrition in the elderly. People over 80 who live alone have deserved this study to detect their situation and potential for action to improve their quality of life. Objectives: To determinate the nutritional status of people over 80 living alone in the area of “La Laguna”, Cádiz. Material and method: In PIAMLA`80 program analyse those parameters and their possible correlations in a group of 342 elderly living alone over 80 years old. Different parameters were measured: Integral Geriatric Evaluation, Barthel, Lawton-Brody, Lobo, Gijon, specific analytical blood chemistry and MNA. Results: In a population of 984 people, were selected 342 initially, but finally the group decreases to 247 people. The mean Barthel was 80.42 points, 5.76 Lawton and Gijon from 11.3 Lobo 26.48. The MNA for the whole population was 24.25/30 detecting only a risk age group in women of 85-95. Correlation between nutrition and the biochemical test values showed positive for haemoglobin (0.19), total protein (0.26), Fe (0.32) and albumin (0.46). Conclusions: In our research we have not detected malnutrition in any age group or gender. The use of nutrition test MNA and its MINI version must be generalized as an accurate, clear, quick and easy tool to use.

scholarly journals Hip fractures among the elderly in Kyoto, Japan: a 10-year study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maki Asada ◽  
Motoyuki Horii ◽  
Kazuya Ikoma ◽  
Tsuyoshi Goto ◽  
Naoki Okubo ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Incidence Rate ◽  
Acute Care ◽  
Hip Fractures ◽  
Age Groups ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Age Group ◽  
Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

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