Current Perspective: Vertigo in the Elderly

Vertigo is a relatively complex condition demanding a skilfully collected and analyzed history. When an elderly patient presents with vertigo, some conditions are most commonly considered highly possible and likely whereas others (prevalent more in young) tend to be excluded from the mental algorithm of the clinician. It also matters to whom the patient presents first-internist, neurologist or the otolaryngologist. An important feature in vertigo in the elderly is the probability of it being multifactorial because of co-morbid conditions that could contribute to the complexity of manifestations. Conducting and appropriately interpreting the bedside tests/maneuvers and thereafter selecting battery of tests/investigations in a sequential manner can clinch the issue of a fair diagnosis in most cases. The Covid Dimension: Any discussion on vertigo would be incomplete without noting the findings on vertigo reported abundantly over the last one year. The compounding COVID angle merits being duly and appropriately considered.

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Regional anaesthesia in the elderly patient a current perspective

Current Opinion in Anaesthesiology ◽

10.1097/aco.0000000000000940 ◽

2020 ◽

Vol 34 (1) ◽

pp. 48-53 ◽

Cited By ~ 1

Author(s):

Eva Corcoran ◽

Brian Kinirons

Keyword(s):

Elderly Patient ◽

Regional Anaesthesia ◽

The Elderly ◽

Current Perspective ◽

A Current

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Management of wet AMD in an elderly patient - case report

Journal of Education, Health and Sport ◽

10.12775/jehs.2021.11.08.002 ◽

2021 ◽

Vol 11 (8) ◽

pp. 24-30

Author(s):

Katarzyna Nowakowska ◽

Przemyslaw Raczkiewicz ◽

Martyna Lewkowicz ◽

Karolina Raksa ◽

Karolina Urbańska

Keyword(s):

Elderly Patient ◽

Visual Acuity ◽

Vision Loss ◽

The Elderly ◽

Geographic Atrophy ◽

Age Related Macular Degeneration ◽

Age Related ◽

One Year ◽

Medical University ◽

Wet Amd

Introduction: Age-related macular degeneration (AMD) is the most common cause of central vision loss in elderly people over 50 years of age. It is characterized by the presence of drusen on the fundus and may be associated with choroidal neovascularization (CNV) or geographic atrophy. AMD is a condition caused by many factors including environmental, genetic, and vascular. Currently, it affects over 25 million people worldwide, but with the progressive aging of the population, the incidence of the disease is increasing. Disease is therefore an important issue in geriatrics.Case report: A 75-year-old patient was referred to the General and Pediatric Ophthalmology Clinic of the Medical University of Lublin due to the three-week deterioration of visual acuity in the left eye. The visual acuity of the left eye was: counting fingers at a distance of 1.5 m. Initial cataracts of this eye and wet AMD were diagnosed. In July 2018. an injection of ranibizumab was administered into the vitreous humor of the left eye. After achieving an improvement in visual acuity to 0.2 (on Snellen charts), in September the patient was qualified to the Drug Program for the treatment of the wet form of AMD. From September to October 2019. the patient received 9 doses of ranibizumab. In October 2019. visual acuity improved to 0.4. In November, due to the unsatisfactory results of the therapy, the drug was changed to aflibercept. The patient received a total of 3 injections of this drug and his visual acuity improved to a value of 0.7. The last injection was given in July 2020 and the clinical condition and visual acuity stabilized. After the end of the drug program, the patient regularly shows up for checkups, and the visual acuity of the left eye has normalized since July 2020. and is now 0.4 (due in part to atrophic changes and scarring).Conclusions: Treatment of the wet form of AMD is a difficult and lengthy process. Early diagnosis of the disease, starting treatment as soon as possible, regular checkups and cooperation with the patient are very important for the success of the therapy. During 3 years of treatment, the patient experienced a significant improvement in visual acuity for one year. The treatment allowed the disease progression to slow down. The morphological condition of the retina improved. The applied treatment and management of the elderly patient turned out to be effective, and the achieved effects of the therapy are satisfactory.

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MALIGNANT MELANOMA. EPIDEMIOLOGY, ANALYTICAL INDICATORS OF THE EFFECTIVENESS OF ONCOLOGICAL SERVICES (POPULATION-BASED STUDY)

Problems in oncology ◽

10.37469/0507-3758-2017-63-2-221-233 ◽

2017 ◽

Vol 63 (2) ◽

pp. 221-233

Author(s):

Vakhtang Merabishvili

Keyword(s):

Malignant Melanoma ◽

Malignant Tumors ◽

The Elderly ◽

Population Based ◽

Special Treatment ◽

Detailed Structure ◽

Population Based Study ◽

Early Stages ◽

One Year ◽

Melanoma Epidemiology

Malignant melanoma of the skin (MMS) is less than 2% (1.74%) among all malignant tumors in Russia but this is more than 10,000 (10236-2015) of new cases. It is important to monitor the trend in dynamics of morbidity and mortality from this cause. From 1995 to 2015 a number of MMS primary cases was more than doubled in absolute numbers and “crude” rates. A slightly smaller increase is indicated by standardized indicators - 62.5% for men and 70.2% for women. Annually in Russia 3670 people die from MMS (2015), which is 1.2% of all cancer deaths. In recent years the previously revealed regularities have been largely preserved: lower rates of specific gravity detected in the early stages among people in the elderly and senile and in a smaller proportion in this group who received special treatment. At the same time a change in the detailed structure of the incidence of women has been revealed where currently the leading localization of MMS was not the lower extremities but the back. The index accuracy improved however the official statistics of the distribution of patients by stages of a disease was significantly distorted (weight of the early stages was increased from the real values). The index of one-year lethality and survival was significantly improved.

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The Depressed Elderly Living in the Community

The British Journal of Psychiatry ◽

10.1192/bjp.157.3.425 ◽

1990 ◽

Vol 157 (3) ◽

pp. 425-427 ◽

Cited By ~ 22

Author(s):

O. Ben-Arie ◽

M. Welman ◽

A. F. Teggin

Keyword(s):

Depressive Disorder ◽

The Elderly ◽

Community Survey ◽

One Year ◽

Elderly Living ◽

Course Of Depression

In a 1982 community survey, 23 elderly respondents were rated as having a depressive disorder by catego. Twenty survivors were followed up three and a half years later. The depression had remitted within one year in seven cases but nine were still depressed. There is a need for ongoing education of GPs about the recognition and course of depression in the elderly.

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Creating a Safer Patient Room Environment: The Contribution of Patient Bed Height

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857921101163 ◽

2021 ◽

Vol 10 (1) ◽

pp. 180-184

Author(s):

Dorothy Taylor ◽

Janice Morse ◽

Andrew Merryweather

Keyword(s):

Elderly Patient ◽

Fall Risk ◽

The Elderly ◽

Lower Leg ◽

Patient Specific ◽

Leg Length ◽

Patient Room ◽

Patient Falls ◽

Sit To Stand ◽

Bed Height

Elderly patient falls are expensive and may cause serious harm. Studies have identified the sit-to-stand-and-walk (STSW) task as the task where the greatest number of elderly patient falls occur. There is a great need to identify the particular movement and environmental conditions that lead to these elderly patient falls. This study begins to address this gap by evaluating the elderly patient during self-selected hospital bed egress. Using an observed fall risk episode (FRE) as a fall proxy, statistically significant parameters were identified which include bed height, pausing prior to initiating gait, level of fall risk, and Stand phase. Low bed height was identified as the least safe bed height. Patient-specific bed height (PSBH) using the patient’s lower leg length (LLL) is recommended. In addition, suggested guidelines are presented for clinical application in setting PSBH without measuring the patient’s LLL.

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