The Reliability of Anamnestic Data in the Management of Clostridium Tetani Infection in Elderly

Background: Tetanus infection remains a significant complication of wounds. Because most tetanus treatment guidelines rely on anamnestic data collected directly from patients, the congruence between anamnesis and laboratory evidence must be verified, especially in the elderly population.Aim: Assess, in both the geriatric population (>65) and the non-geriatric one, the reliability of anamnestic data for managing patients with tetanus-risk wounds, identified categories of populations most exposed to non-vaccination coverage, and assessed the agreement of the Tetanos Quick Stick (TQS) results with the therapy performed (administration of tetanus vaccine or immunoglobulin).Methods: In this retrospective single-center observational study, patients were asked their immunization status against tetanus vaccination. The decision to administer a vaccine or immunoglobulin was therefore clinical and based on anamnestic criteria. The TQS test was then given to patients who were unaware of their immunity status. Patients who thought they knew it but were not sure were given the TQS test to determine whether the anamnestic collection was supported by the test. The TQS test results were compared with the anamnestic data.Results: Most patients, geriatric and not geriatric, did not know their immune status. Among those who reported knowing their immune status, there was no agreement between the vaccine coverage declared by patients and the TQS test results (p < 0.001), mainly in geriatric patients but also in the control group. Elderly and women had significantly lower positive TQS test results (p < 0.001). There was a statistically significant discrepancy (p < 0.001) between the therapy based on anamnestic data and the TQS test results.Conclusion: The reliability of anamnestic data for the management of patients with tetanus-risk wounds is low and decreases with age, becoming minimal in geriatric patients. Elderly and women are less likely to have an effective vaccination status against tetanus.

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Influence of the Ethnic Affiliation, Level of Education and Place of Living on Oral Health at Geriatric Population with Total and Partial Dentures in Republic of Macedonia

PRILOZI ◽

10.1515/prilozi-2015-0088 ◽

2015 ◽

Vol 36 (3) ◽

pp. 130-137

Author(s):

Natasha Stavreva ◽

Ljuben Guguvcevchi ◽

Biljana Kapusevska

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Urban Areas ◽

Geriatric Patients ◽

Demographic Characteristics ◽

Control Group ◽

Geriatric Population ◽

Level Of Education ◽

Ethnic Affiliation

Abstract Introduction. Health is the main component of the quality of life, while oral health is component of the general health. The socio-demographic characteristics are one of the important factors for perception of the oral health and the quality of life. The main purpose of this study was to perform an evaluation of the quality of life of geriatric patients (older than 65) with built-in oral prosthetic dentures depending on the ethnic affiliation, level of education and place of living, as socio-demographic characteristics. Materials and methods. The survey was a prospective transversal (cross-sectional) study conducted among 165 institutionally sheltered patients at the Gerontology Institute (inspected group - IG) and 170 patients from the dental specialist clinics (control group CG) at the age of 65 and older. The statistical program SPSS for Windows ver. 13.0 was used for statistical processing. Results and discussion. Patients with upper and lower total dentures dominated (43.6% vs. 26.5%). The highest GOHAI score had the other ethnicities of IC (32.08) and Roma of IG (31.00), while the lowest was in the Albanians of CG (25.91). The highest value of 30.15 had the IG of patients living in urban areas. Conclusion. The quality of life and oral health of the geriatric patients are at unsatisfactory level, with significant influence of the place of living and insignificant influence of the ethnic affiliation and level of education.

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Pain and Addiction in Older Adults (DRAFT)

10.1093/med/9780190265366.003.0031 ◽

2018 ◽

Author(s):

Nelly A. Buckalew

Keyword(s):

Older Adults ◽

Physical Examination ◽

Geriatric Patients ◽

Substance Misuse ◽

The Elderly ◽

Opioid Misuse ◽

Patient History ◽

Geriatric Population ◽

Younger Adults ◽

Tabular Format

Addressing unique effects of both addiction and analgesia on older adults, this chapter defines the geriatric population and proceeds to discuss the recognition of addiction or substance misuse in it. There is little argument that the elderly have special diagnostic concerns and management needs that are imposed upon those of younger adults. The concept of the pain signature is introduced as a measure of the functions with which the individual’s pain interferes. Four instruments serving as diagnostic aids are included in tabular format: the pain signature elements; a list of recommended patient history queries; suggested components of the review of systems; and special components of the physical examination. The tables are geared specifically toward geriatric patients. The two central themes of the chapter are treatment of pain, and the treatment of opioid misuse and addiction.

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Geriatric and Student Perceptions following Student-led Educational Sessions

INNOVATIONS in pharmacy ◽

10.24926/iip.v9i1.943 ◽

2018 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Kristin Janzen ◽

Lauren N. Kormelink ◽

Lindsay Saum ◽

Sarah A. Nisly

Keyword(s):

Student Perceptions ◽

Geriatric Patient ◽

Geriatric Patients ◽

Human Subjects ◽

Community Setting ◽

The Elderly ◽

Original Research ◽

Positive Finding ◽

Geriatric Population ◽

Innovation Fund

Objective: The objective of this study was to measure the effect of student-led educational events on geriatric patient and student participant perceptions in a community setting. Methods: Students led three events at a senior community center, focusing on learning and memory, sleep hygiene, and arthritis pain. The participants were geriatric patients who themselves were providers of support to homebound peers (“clients”) through an independently organized program. Geriatric participants completed pre- and post-event surveys to measure changes in familiarity with the topics. Student participants also completed pre- and post-event surveys that tracked changes in their comfort in working with the geriatric population. Results: Each event demonstrated at least one positive finding for geriatric patients and/or their clients. Students reported increased comfort in working with and teaching the geriatric population following the first and third events, but not the second. Conclusion: Student-led educational sessions can improve perceived health-related knowledge of geriatric participants while simultaneously exposing students to the geriatric patient population. Overall, both students and geriatric participants benefited from these events. Practice Implications: Incorporation of single, student-led educational events could be mutually beneficial to students and the elderly population in the community and easily incorporated into any healthcare curriculum. Funding:This work was supported by a Butler University Innovation Fund Grant. Treatment of Human Subjects: IRB review/approval required and obtained Type: Original Research

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Evaluation and Treatment of Posterior Tibialis Tendon Insufficiency in the Elderly Patients

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459318821461 ◽

2019 ◽

Vol 10 ◽

pp. 215145931882146

Author(s):

Tochukwu C. Ikpeze ◽

James D. Brodell ◽

Raymond E. Chen ◽

Irvin Oh

Keyword(s):

Elderly Patients ◽

Geriatric Patients ◽

The Elderly ◽

Journal Articles ◽

Geriatric Population ◽

Gait Biomechanics ◽

Second Stage ◽

Radiographic Outcomes ◽

Stage Disease ◽

Hindfoot Fusion

Introduction: Posterior tibialis tendon insufficiency is the most common cause of adult acquired flatfoot deformity in elderly patients. We performed a literature search of primary and secondary journal articles pertaining to posterior tibialis tendon insufficiency in the geriatric population. We examined relevant data from these articles regarding current evaluation in addition to both conservative and advanced treatment approaches that correspond to disease severity. Significance: There is a paucity of literature to guide treatment of posterior tibialis tendon insufficiency in the elderly, and this condition may be more prevalent in geriatric patients than previously realized. Results: Posterior tibialis tendon insufficiency is an acquired defect that affects 10% of the geriatric population and disproportionately affects women. It is typically caused by degenerative changes. There are four primary stages of posterior tibialis tendon with subcategorizations that range from mild to severe. Conservative treatment with a variety of available ankle braces and non-steroidal anti-inflammatory medications are typically used to treat the first and second stage disease. Surgical repair is warranted for advanced second stage and above posterior tendon insufficiency. A variety of techniques have been proposed, and can include tendon transfer, hindfoot fusion, and even total ankle arthroplasty in extreme cases. Conclusion: Posterior tibialis tendon insufficiency causes marked discomfort and alters normal gait biomechanics. Elderly patients typically present with more severe manifestations of the disease. For patients requiring surgery, and especially geriatric patients, the ideal treatment is thought to be a procedure that is minimally invasive in order to maximize positive outcomes for elderly patients. More work is needed to examine clinical and radiographic outcomes of geriatric patients treated for posterior tibialis tendon insufficiency.

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Benefits of cochlear implantation in elderly patients

Otolaryngology ◽

10.1067/mhn.2000.98317 ◽

2000 ◽

Vol 122 (4) ◽

pp. 602-606 ◽

Cited By ~ 1

Author(s):

Young-Je Shin ◽

Bernard Fraysse ◽

Olivier Deguine ◽

Olivier Valès ◽

Marie-Laurence Laborde ◽

...

Keyword(s):

Elderly Patients ◽

Cochlear Implantation ◽

The Elderly ◽

Cost Utility ◽

Control Group ◽

Test Results ◽

Speech Discrimination ◽

Postoperative Course ◽

Open Set

Cochlear implantation in elderly patients is a questionable subject. The purpose of this study was to evaluate the procedure and its outcome, the postoperative course, and the audiologic and social benefits of cochlear implantation in this population. Twenty-seven patients older than 60 years were compared with a control group of 15 adult patients. This retrospective study analyzed data concerning the outcome of the procedure, postoperative course, postoperative orthophonic test results, and answers of a questionnaire assessing the changes in communication, perception, and social outcomes. The procedure was uneventful in both groups. Minor complications were not more frequent in elderly patients. Orthophonic test results were comparable in both groups. At 12 months, 83% of the elderly patients had an open-set speech discrimination score above 60%. The benefits of cochlear implantation in terms of the quality of life are not statistically different with younger patients. Cost-utility analysis might support these findings.

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The Safety of Systemic Treatments That Can Be Used for Geriatric Psoriasis Patients: A Review

Dermatology Research and Practice ◽

10.1155/2012/367475 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 9

Author(s):

Jillian W. Wong ◽

John Y. M. Koo

Keyword(s):

Geriatric Patients ◽

The Elderly ◽

Severe Psoriasis ◽

Age Group ◽

Elderly Age ◽

Geriatric Population ◽

Immune System Function ◽

Systemic Treatments ◽

Treatment Safety ◽

Systemic Agents

Background. Patients with moderate-to-severe psoriasis are often treated with systemic immunosuppressant agents that decrease immune system function. For the elderly, these medications are often problematic due to their already immunosuppressed state and comorbidities. However, there are few studies examining the effects of these medications on the elderly age group. Therefore, there is often discomfort among dermatologists treating elderly patients with psoriasis in utilizing systemic agents, frequently resulting in inadequate treatment.Objective. We review the safety profiles of systemic treatments often used to treat psoriasis and their possible adverse risks to the geriatric population.Methods. We conducted a search of PubMed’s Medline database of articles published from 2000 to 2011, which resulted in 14 articles.Conclusion. Treating geriatric patients with moderate-to-severe psoriasis remains a challenge due to immunosenescence and comorbidities. More studies focusing on psoriasis treatment safety in the geriatric population are needed.

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Effect of Yoga on Balance in Geriatric Population

International Journal of Scientific Research in Science and Technology ◽

10.32628/ijsrst11962130 ◽

2019 ◽

pp. 595-605

Author(s):

Krishna Ketan Patel ◽

Mayura Deshmukh ◽

Tushar Palekar

Keyword(s):

Older Adults ◽

Well Being ◽

The Elderly ◽

Complementary Therapy ◽

Body Awareness ◽

Control Group ◽

Clinical Test ◽

Geriatric Population ◽

Age Related ◽

Experimental Group

Background : The geriatric population is defined as population aged 60 years and above. (1)During this age many of the systems undergo deterioration. Balance problems in elderly are most commonly due to multi factorial condition which may include age related or disease-related declines in the balance system. Research shows that altered balance is the greatest collaborator towards falls in the elderly with a high correlation between balance deficit and the incidence of falls. Iyengar yoga, one of the active, or Hatha, yoga techniques, is a system for developing physical and mental well-being through stretching of all muscle groups for strength, flexibility, and physical balance. Yoga as a complementary therapy is thought to be more therapeutic than traditional exercise because it involves active engagement between mind and body. Its practice has been associated with increased muscle strength, endurance, flexibility, range of motion and cardiopulmonary endurance. It mainly works on increasing body awareness and proprioception, which will lead to improvement of balance in older adults. Objectives: To compare pre and post score of Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M). To compare pre and post score of Time up and go test. Materials and Methodology: This was an experimental study that included 40 participants, healthy older adults between the age group 60-75 years, both male and female. The subjects were randomly divided in to 2 groups; Group A was the experimental group whereas group B was the control group. The experimental group was made to perform yogasanas for the duration of four weeks for 5 times a week whereas the control group was not given any intervention. Result and Conclusion: The study conducted concludes that yogasanas are effective in improving balance in elderly individuals at the end of four weeks compared to control group. Thus, it can be used clinically to improve balance in geriatric population.

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Antidepressant Drug Therapy in the Elderly: Enhancing Safety and Compliance

The International Journal of Psychiatry in Medicine ◽

10.2190/uhl6-0x4w-frng-8pff ◽

1987 ◽

Vol 16 (1) ◽

pp. 1-19 ◽

Cited By ~ 6

Author(s):

Angelos Halaris

Keyword(s):

Affective Disorders ◽

Geriatric Patients ◽

Tricyclic Antidepressants ◽

Adverse Reactions ◽

Antidepressant Drug ◽

The Elderly ◽

Review Article ◽

Drug Usage ◽

Geriatric Population ◽

Treatment Of Depression

This review article addresses some of the complex issues surrounding antidepressant drug usage among elderly depressives. While primarily geared toward the psychiatrist in general practice, the article provides useful information for the nonpsychiatric physician who is frequently called upon to evaluate and treat affective disorders in the geriatric population. Since tricyclic antidepressants and lithium are the most commonly used psychotropic drugs in the treatment of depression, their side effects and adverse reactions are discussed specifically as these relate to the elderly. Suggestions are offered on how to improve safety and enhance compliance. Brief mention is made of the monoamine oxidase inhibitors and the second generation antidepressants. Dose ranges are recommended for use of these agents in geriatric patients. Finally, a section of the article reviews the most commonly encountered drug interactions between tricyclic and a variety of other psychotropic and nonpsychotropic drugs.

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Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2018: the Influenza Complications Alert Network (FluCAN)

Communicable Diseases Intelligence ◽

10.33321/cdi.2019.43.48 ◽

2019 ◽

Vol 43 ◽

Cited By ~ 2

Author(s):

Allen C Cheng ◽

Mark Holmes ◽

Dominic E Dwyer ◽

Sanjaya Senenayake ◽

Louise Cooley ◽

...

Keyword(s):

Surveillance System ◽

Hospital Admissions ◽

Influenza Season ◽

Vaccine Coverage ◽

The Elderly ◽

Nucleic Acid Detection ◽

Control Group ◽

Surveillance Program ◽

Influenza B ◽

Medical Comorbidities

The Influenza Complications Alert Network (FluCAN) is a sentinel hospital-based surveillance program that operates at sites in all jurisdictions in Australia. This report summarises the epidemiology of hospitalisations with laboratory-confirmed influenza during the 2018 influenza season. In this observational surveillance system, cases were defined as patients admitted to any of the 17 sentinel hospitals with influenza confirmed by nucleic acid detection. Data were also collected on a frequency-matched control group of influenza-negative patients admitted with acute respiratory infection. During the period 3 April to 31 October 2018 (the 2018 influenza season), 769 patients were admitted with confirmed influenza to one of 17 FluCAN sentinel hospitals. Of these, 30% were elderly (≥65 years), 28% were children (<16 years), 6.4% were Aboriginal and Torres Strait Islander peoples, 2.2% were pregnant and 66% had chronic comorbidities. A small proportion of FluCAN admissions were due to influenza B (13%). Estimated vaccine coverage was 77% in the elderly (≥65 years), 45% in non-elderly adults with medical comorbidities and 26% in children (<16 years) with medical comorbidities. The estimated vaccine effectiveness (VE) in the target population was 52% (95% CI: 37%, 63%). There were a smaller number of hospital admissions detected with confirmed influenza in this national observational surveillance system in 2018 than in 2017, with the demographic profile reflecting the change in circulating subtype from A/H3N2 to A/H1N1.

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Effects of the Low-Osmolality Contrast Medium Ioversol (Optiray) on Renal Function in a Geriatric Population

Acta Radiologica ◽

10.1177/02841851960373p2101 ◽

1996 ◽

Vol 37 (3P2) ◽

pp. 950-953

Author(s):

J.-P. Louvel ◽

E. Primard ◽

J. Henry ◽

C. Houlette ◽

A. Weinstein ◽

...

Keyword(s):

Serum Creatinine ◽

Creatinine Clearance ◽

Contrast Medium ◽

The Elderly ◽

Elderly Subjects ◽

Control Group ◽

Geriatric Population ◽

Iodinated Contrast ◽

Significant Difference ◽

Associated Risk Factors

Purpose: To assess the incidence of nephrotoxicity following i.v. injection of the iodinated low-osmolality contrast medium ioversol 300 (Optiray) in a geriatric population compared with a control group aged under 60 years, neither group presenting any associated risk factors. Material and Methods: CT with i.v. bolus injection of ioversol 300 mg I/ml was performed at a mean dose of 1.36±0.06 ml/kg (range 1–2 ml/kg b.w.) in 47 patients aged over 69 years. Serum creatinine level was measured and creatinine clearance was calculated at 24, 48 and 72 h after the examination, and compared to a reference serum creatinine value taken before CT. The findings were compared with a control group of 44 patients aged under 60 years. Results: No significant increase in serum creatinine (+0.6 mmol/l) or in creatinine clearance (+0.7 ml/min) was found during the course of 3 days after the injection. Only one patient (aged 82) presented an increase of 25% in serum creatinine (109 mmol/l). Conclusion: The trial did not demonstrate any significant difference between the 2 groups, although the elderly patients had a subclinical renal impairment revealed by the decrease of the initial creatinine clearance. The use of low-osmolality ioversol makes it possible to perform examination with an iodinated contrast agent without increasing the incidence of nephrotoxicity in elderly subjects.

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