scholarly journals Occurrence of Epileptic Complications in Patients with Cerebrovascular Disease in Charge to the Home Care Center: A Clinical Experience

2021 ◽  
Vol 2 (3) ◽  
pp. 213-215
Author(s):  
F Zarola ◽  
B Middei
Keyword(s):  
Home Care ◽  
Cerebrovascular Disease ◽  
Care Center ◽  
Rare Event ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Practical Experience ◽  
Minor Stroke ◽  
Secondary Epilepsy

Most studies in literature about the occurrence of the so-called vascular epilepsy suggest that this complication is an episodic and relatively rare event mostly due to clinical conditions related to haemorrhagic ictus while chronic vascular disease (multifocal vascular encephalopathy, vasculopathy with lacunar infarcts or minor stroke and ischemic strokes) is not usually considered as risk factors for the onset of secondary epilepsy. Furthermore, the epilepsy of the elderly is often ascribed to the atrophy of the brain tissues linked to both age and chronic hypoxia induced by Atherosclerosis (ATS) or a complication of pharmacological therapies in the elderly (anticholinesterases, neuroleptics, anticoagulants). In fact, in our clinical and practical experience in the district outpatients clinic and home care center, numerous clinical cases have been subject to diagnosis and treatment of late epilepsy following an ischemic stroke. In this study we had thepurpose to describe our experience of occurrence of epileptic complications in patients with morewide Cerebrovascular Disease (CVD) patterns. We studied a group of 15 patients (8 Male and 7 Female) affected by CVD and by recent recently onset epilepsy. Our study found that Cerebrovascular disease CVD constitutes a significant risk factor for secondary epilepsy in the groups with elder age even though younger subjects can be involved after being affected by relevant cerebrovascular events. In opposition to the opinion assumed in common clinical practice an important part of these causal events are ischemic and non-haemorrhagic as previously known.

HOME CARE IN OUTPATIENT CARE – STATE AND DEVELOPMENT IN BULGARIA

2018 ◽  
Vol 28 (2) ◽  
pp. 571-574
Author(s):  
Ivanka Stambolova ◽  
Stefan Stambolov
Keyword(s):  
Home Care ◽  
Outpatient Care ◽  
Care Service ◽  
Elderly Care ◽  
Care Center ◽  
Elderly Person ◽  
Chronically Ill ◽  
The Elderly ◽  
Legal Regulation ◽  
Health And Social Care

In outpatient care the home care, including hospices, is recognized as a model for providing quality, cost-effective and charitable care. The focus is mainly on the care that helps everyday lifeof the patient as well as the relatives, rather than on treatment, and in most cases it takes place in the patients' home. In Europe, in recent years there has been a real "boom" in home care due to demographic processes linked to increased needs for elderly care and chronically ill under the conditions of limited financial resources.In outpatient medical care in our country by means of a national framework contract there are regulated visits to the patient's home by a doctor, as well as visits by medical staff employed by him - nurse, midwife, medical assistant / paramedic / for manipulation, counseling and monitoring. At the same time there is no regulated legal activity in the Republic of Bulgaria, which is essentially the subject of home care.Since 1994 „Caritas“ has carried out the "Home Care" service, which provides a complex - health and social care for over 360 sick adults in a place where the elderly person feels the most comfortable - in their own home. „Caritas Home Care“ is provided by mobile teams of nurses and social assistants who visit the elderly at home and provide them with the necessary care according to their health and social needs.With the establishment of the first „Home Care Center“ in Lozenets region, Sofia, with the support of the PHARE ACCESS program in 2003, the Bulgarian Red Cross introduces in Bulgaria an integrated model for provision of health care and social services in the home of adults, chronically ill and people with permanent disabilities. To date, there are a number of problems in home care related to the realization of home care for patients in need in out-of-hospital settings: lack of legal regulation for home care, lack of qualified staff in outpatient care; lack of organization and structures for care; unsettled funding and the inability of the part of the population that is most in need of care to pay for it, there is no regulation to control the activity. Although home care began over 20 years ago, our country is yet to make its way to the European program called „Home care in Europe“.

scholarly journals 453 - The effect of ageing in personality and emotions

2020 ◽  
Vol 32 (S1) ◽  
pp. 173-173
Author(s):  
Catarina Pedro ◽  
Mariana Duarte ◽  
Beatriz Jorge ◽  
Daniela Freitas
Keyword(s):  
Old Age ◽  
Emotional Processing ◽  
Personality Development ◽  
Early Adulthood ◽  
Significant Risk ◽  
Marked Change ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Big Five Personality ◽  
Age Related

Introduction:Personality and emotions have not been studied as thoroughly as cognition in old age. Recent research suggests personality changes across the entire life span, through middle age and even into old age. Thus, the previous assumption of stability in personality traits from early adulthood has been challenged and novel approaches to the study of personality development have emerged.Objectives:The aim of this presentation is to describe the effects of the ageing process in personality and emotions.Methods:A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords.Results:When older adults compare their current and past selves, they usually perceive a subjective growth in personality. Descriptive research suggests that the big five personality characteristics (neuroticism, extraversion, openness, agreeableness and conscientiousness) remain generally stable over the lifespan, despite variations in life experiences. Some studies revealed age-related linear decrease in extraversion. One of the studies found that hearing impairment, already identified as a significant risk factor for social isolation, was related to this decline in extraversion. Although levels of neuroticism tends to go down over the course of adulthood, the increased vulnerabilities that accompany old age may amplify neurotic traits, increasing worries about physical health and memory, common features of depression in the elderly. Emotions, relative to more neutral knowledge and skills, increase in later years. Elderly have better control over emotions than do younger adults, they reason more flexibly about emotion-laden dilemmas and remember emotionally charged information better than neutral facts. Older people also rely more often on emotion-focused forms of coping, as opposed to active, problem-solving approaches.Conclusions:Core features of personality seem to remain relatively stable throughout adulthood and any marked change in mood or social behavior may indicate a disorder. However, more subtle reordering of personal priorities and shifts in coping styles are common with normal ageing. The richness of emotional processing in older persons runs counter to the generally declining patterns seen in many cognitive and physical skills.

scholarly journals Modulation of Bacterial Pathogenesis by Oppressive Aging Factors: Insights into Host-Pneumococcal Interaction Strategies

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Pooja Shivshankar
Keyword(s):  
Cellular Senescence ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Receptor Expression ◽  
Chronic Obstructive ◽  
Related Phenomenon ◽  
Aged Mice ◽  
Inflammatory Status ◽  
Age Related

Streptococcus pneumonia, (Spn, the pneumococcus), is the leading cause of community-acquired pneumonia (CAP) and is responsible for 15–40% deaths in the elderly worldwide. A primed inflammatory status is a significant risk factor for the increased severity of infectious diseases among the elderly (≥65 years of age). Studies have shown that expression of host receptors that the pneumococci bind to invade the tissues are increased thereby increasing the susceptibility to pneumococcal challenge in aged mice. Cellular senescence, an age-related phenomenon that leads to cell cycle arrest may also contribute to increased inflammation in aged mice. Evidence of cellular senescence in aged lungs of humans and mice adds credits to the concept of inflammaging and enhanced bacterial ligands expression during aging. Furthermore, cell senescence has been shown to occur in age-associated lung pathologies such as idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) that may predispose the elderly to pathogenic assaults, including S. pneumoniae. This review highlights the aspects of: chronic inflammation in the aged population; contribution of cellular senescence to age-associated inflammation and their impact on host receptor expression; and, increased susceptibility of fibrosis and emphysematous lesions-bearing lungs to microbial infections.

scholarly journals The Biology and Pathobiology of Glutamatergic, Cholinergic, and Dopaminergic Signaling in the Aging Brain

2021 ◽  
Vol 13 ◽  
Author(s):  
Anna Gasiorowska ◽  
Malgorzata Wydrych ◽  
Patrycja Drapich ◽  
Maciej Zadrozny ◽  
Marta Steczkowska ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Experimental Studies ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Aging Brain ◽  
Detailed Knowledge ◽  
Age Related ◽  
Parkinson’S Diseases ◽  
The Brain

The elderly population is growing worldwide, with important health and socioeconomic implications. Clinical and experimental studies on aging have uncovered numerous changes in the brain, such as decreased neurogenesis, increased synaptic defects, greater metabolic stress, and enhanced inflammation. These changes are associated with cognitive decline and neurobehavioral deficits. Although aging is not a disease, it is a significant risk factor for functional worsening, affective impairment, disease exaggeration, dementia, and general disease susceptibility. Conversely, life events related to mental stress and trauma can also lead to accelerated age-associated disorders and dementia. Here, we review human studies and studies on mice and rats, such as those modeling human neurodegenerative diseases, that have helped elucidate (1) the dynamics and mechanisms underlying the biological and pathological aging of the main projecting systems in the brain (glutamatergic, cholinergic, and dopaminergic) and (2) the effect of defective glutamatergic, cholinergic, and dopaminergic projection on disabilities associated with aging and neurodegenerative disorders, such as Alzheimer’s and Parkinson’s diseases. Detailed knowledge of the mechanisms of age-related diseases can be an important element in the development of effective ways of treatment. In this context, we briefly analyze which adverse changes associated with neurodegenerative diseases in the cholinergic, glutaminergic and dopaminergic systems could be targeted by therapeutic strategies developed as a result of our better understanding of these damaging mechanisms.

scholarly journals Falls As a Problem of an Aging Population, a Modern Look at Risk Factors and Assessment Methods. Role of Fear of Falls in Increasing their Risk

2021 ◽  
Vol 11 (6) ◽  
pp. 433-441
Author(s):  
V. N. Larina ◽  
I. A. Samkova ◽  
E. V. Kudina
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Prevention Measures ◽  
Medical Specialties ◽  
Global Trend ◽  
Risk Factors For Falls ◽  
Fear Of Falls

The article presents modern views on the problem of falls in the elderly. There is a global trend of changing the demographic situation - the permanent increase in the proportion of elderly and senile people in the general population, the issues of geriatrics as one of the medical specialties are becoming the most relevant. Among the problems that geriatricians and all specialists involved in the treatment of elderly patients have to solve, one of the most serious is the problem of falls. The article provides a medical review of the assessment of the frequency of falls depending on gender, age, diseases and external factors. The main risk factors for falls and their prevention measures are discussed in detail. Special attention is given to the fear of falls as a significant risk factor. The methods of validation the risk factor with the use of unified questionnaires - “The scale of assessment of the fear of fa lls” and “the Falls efficacy scale” are presented. The purpose of this article is to attract the attention of practitioners to the problem of falls and the fear of falls as one of the significant risk factors, methods of its identification and prevention

scholarly journals Obesity, A Risk Factor for Mortality in SARS CoV-2 Infection: A Narrative Systematic Review

2021 ◽  
Author(s):  
Sekhar Reddy ◽  
Mohd Ashraf Ganie ◽  
Parvaiz A. Koul ◽  
Tajali Sahar ◽  
Shaista Showkat
Keyword(s):  
Risk Factor ◽  
Independent Risk Factor ◽  
Elderly Population ◽  
Age Groups ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Novel Coronavirus ◽  
Key Terms

AbstractSARS CoV-2 is a β-coronavirus responsible for the current COVID-19 pandemic. Although there is increase severity and mortality described in the elderly population and people with co-morbidities, all age groups are susceptible to COVID-19. Recent data showed that obesity has also emerged as a significant risk factor for COVID-19 mortality. As per the WHO, most of the world's population lives in countries where obesity is highly prevalent. In this context, we aimed to review various studies that showed obesity as an independent risk factor for mortality in SARS CoV-2 infection. We followed the PRISMA guidelines to search for two databases including PubMed and Google Scholar using the key terms “COVID-19, OBES* and MORTALITY,” SARS CoV-2, OBES* and MORTALITY” “COVID-19, OBESITY, and MORTALITY,” SARS Cov-2, OBESITY and MORTALITY,” respectively, up to August 3, 2020. Twelve studies were finally included in this review after applying inclusion and exclusion criteria. All 12 studies included in the review consistently showed that obesity is a risk factor for mortality in patients with SARS CoV-2 infection. These studies have also shown evidence that obesity leads to increased hospitalization, ICU admission, increased need for mechanical ventilation, and poor prognosis among patients with SARS CoV-2 infection. Obesity is an independent risk factor for mortality in patients infected with this novel coronavirus. Appropriate triage, monitoring, and vigilance are required while dealing with individuals with obesity with SARS CoV2 infection, especially in the young obese population. More epidemiological studies need to be done taking BMI also into consideration in COVID-19 patients to find the exact cause of increased severity and mortality and develop appropriate preventive and therapeutic strategies.

Hip Fracture

2019 ◽  
pp. 281-293
Author(s):  
Franchesca Arias ◽  
Catherine C. Price ◽  
Jeffrey C. Gadsden
Keyword(s):  
Risk Factor ◽  
Hip Fracture ◽  
Significant Risk ◽  
Public Health Problem ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Age Related ◽  
Significant Public Health ◽  
Continuous Nerve Block ◽  
Fascia Iliaca Block

This chapter discusses hip fracture, which is a significant public health problem associated with substantial morbidity and mortality. Pain with hip fracture is often severe but despite this is frequently undertreated in the elderly population. Untreated pain not only is inhumane but also is a significant risk factor for delirium in this population that is already at increased risk due to age-related cognitive decline. Hip fracture patients benefit from early intervention with regional analgesic techniques such as femoral or fascia iliaca block, as well as a scheduled regimen of nonopioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory medications. While opioids are known to contribute to risk for delirium, pain itself is a much stronger risk factor, and when nonopioid options are exhausted, opioids should be carefully considered. Continuous nerve block techniques provide opportunities for extended pain relief, which is associated with improved recovery profile, greater satisfaction, and a decreased risk for complications.

scholarly journals An Etiologic Profile of Anemia in 405 Geriatric Patients

Anemia ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Tabea Geisel ◽  
Julia Martin ◽  
Bettina Schulze ◽  
Roland Schaefer ◽  
Matthias Bach ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Geriatric Patients ◽  
Transferrin Saturation ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
The Elderly ◽  
Minor Role ◽  
Timely Initiation ◽  
Few Data ◽  
Hospitalized Geriatric Patients

Background. Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients.Methods. Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine) in addition to medical history and demographics.Results. Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1%) in a mild form. Anemia was primarily due to iron deficiency (65%), frequently due to underlying chronic infection (62.1%), or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role.Conclusion. Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.

scholarly journals Ventilator-Associated Pneumonia in Neurosurgical Patients: A Tertiary Care Center Study

2019 ◽  
Vol 41 (2) ◽  
pp. 40-44 ◽  
Author(s):  
Dipendra K Shrestha ◽  
Binod Rajbhandari ◽  
Amit Pradhanang ◽  
Gopal Sedain ◽  
Sushil K Shilpakar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Risk Factor ◽  
Head Injury ◽  
Prolonged Mechanical Ventilation ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Ventilator Associated Pneumonia ◽  
Neurosurgical Patients

Introduction: Ventilator-associated pneumonia (VAP) is a well recognized complication in patients who are admitted to the Intensive Care Unit (ICU). A number of factors have been suspected or identified to increase the risk of VAP in Neurosurgical patients. Early and rapid diagnosis and initiation of the appropriate antibiotic treatment reduce mortality and decrease the development of MDR organisms. The aim of our study is to determine the incidence of VAP in the neurosurgical patients and also to assess the probable contributing neurosurgical risk factors and find out the causative bacterial pathogens and the resistant pattern of these bacteria in neurosurgical patient in ICU of our institute Methods: A retrospective observational study of 106 neurosurgical patients who were on mechanical ventilation for more than 48 hours was done. Results: Out of 106 patients, 35 patients fulfilled the clinical and microbiological criteria for the diagnosis of VAP. The commonest age group involved was between 15-25 years of age with male preponderance. Head injury was the commonest etiology. There was a linear correlation between the number of days in ICU and the development of VAP. The majority of the pathogen isolated were gram-negative bacteria and all were sensitive to Colistin. Conclusion: Head injury is a significant risk factor for VAP. Prolonged mechanical ventilation is an important risk factor for VAP.

scholarly journals Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy

2015 ◽  
Vol 13 (2) ◽  
pp. 221-225 ◽  
Author(s):  
Monique Sedlmaier França ◽  
Pedro Luiz Serrano Usón Junior ◽  
Yuri Philippe Pimentel Vieira Antunes ◽  
Bernard Lobato Prado ◽  
Carlos del Cistia Donnarumma ◽  
...  
Keyword(s):  
Care Center ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Adherence To Guidelines ◽  
Antiemetic Prophylaxis ◽  
Chemotherapy Regime ◽  
American Society ◽  
Higher Doses ◽  
Antineoplastic Chemotherapy

ABSTRACT Objective: To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. Methods: A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. Results: We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). Conclusion: We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines.

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