Clinical Utility of Delorme Operation for Treatment of Rectal Prolapse in the Elderly: Incontinence Score Improvement

The elderly population is increasing globally, putting more pressure on aged care and public health systems. To address this issue and help increase the independence of older people, different digital technologies, including the Internet of things (IoT), can play an important role. Although there has been an increase in the number of studies in this field, most of them concentrate on IoT applications in elderly care from a technology perspective, with very little contribution from the clinical side. Therefore, this paper aims to investigate and identify the available IoT applications and their clinical utility for common diseases in elderly people. The results of this study could be useful for information technology professionals in developing and understanding the clinical requirements for IoT applications in healthcare for older people. Clinicians will also be informed about the clinical possibilities of using IoT devices in this area. Based on our findings, future research should focus on enhancing the clinical utility of current IoT applications in different settings and on developing new applications to support practitioners and older people.

Download Full-text

Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure

International Psychogeriatrics ◽

10.1017/s1041610217000916 ◽

2017 ◽

Vol 29 (10) ◽

pp. 1585-1593 ◽

Cited By ~ 19

Author(s):

Sarah J. Richardson ◽

Daniel H. J. Davis ◽

Giuseppe Bellelli ◽

Wolfgang Hasemann ◽

David Meagher ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Medical Records ◽

Clinical Utility ◽

The Elderly ◽

Testing Procedure ◽

Cognitive Tests ◽

Attention Task ◽

High Diagnostic Accuracy ◽

Eye Opening ◽

Delirium Superimposed On Dementia

ABSTRACTBackground:Detecting delirium superimposed on dementia (DSD) can be challenging because assessment partly relies on cognitive tests that may be abnormal in both conditions. We hypothesized that a combined arousal and attention testing procedure would accurately detect DSD.Methods:Patients aged ≥70 years were recruited from five hospitals across Europe. Delirium was diagnosed by physicians using DSM-5 criteria using information from nurses, carers, and medical records. Dementia was ascertained by the Informant Questionnaire on Cognitive Decline in the Elderly. Arousal was measured using the Observational Scale of Level of Arousal (OSLA), which assesses eye opening, eye contact, posture, movement, and communication. Attention was measured by participants signaling each time an “A” was heard when “S-A-V-E-A-H-A-A-R-T” was read out.Results:The sample included 114 persons (mean age 82 years (SD 7); 54% women). Dementia alone was present in 25% (n = 28), delirium alone in 18% (n = 21), DSD in 27% (n = 31), and neither in 30% (n = 34). Arousal and attention was assessed in n = 109 (96%). Using OSLA, 83% participants were correctly identified as having delirium (sensitivity 85%, specificity 82%, AUROC 0.92). The attention task correctly classified 76% of participants with delirium (sensitivity 90%, specificity 64%, AUROC 0.80). Combining scores correctly classified 91% of participants with delirium (sensitivity 84%, specificity 92%, AUROC 0.94). Diagnostic accuracy remained high in the subgroup with dementia (93% correctly classified, sensitivity 94%, specificity 92%, AUROC 0.98).Conclusions:This combined arousal–attention assessment to detect DSD was brief yet had high diagnostic accuracy. Such an approach could have clinical utility for diagnosing DSD.

Download Full-text

Rectal Prolapse in the Elderly

Pelvic Floor Dysfunction and Pelvic Surgery in the Elderly ◽

10.1007/978-1-4939-6554-0_23 ◽

2017 ◽

pp. 313-317

Author(s):

Susan L. Gearhart

Keyword(s):

Rectal Prolapse ◽

The Elderly

Download Full-text

Lomas-Cooperman technique for rectal prolapse in the elderly patient

Techniques in Coloproctology ◽

10.1007/s10151-006-0261-6 ◽

2006 ◽

Vol 10 (2) ◽

pp. 106-110 ◽

Cited By ~ 1

Author(s):

J. E. Mansilla ◽

G. C. Bannura ◽

J. P. Contreras ◽

A. E. Barrera ◽

C. L. Melo ◽

...

Keyword(s):

Elderly Patient ◽

Rectal Prolapse ◽

The Elderly

Download Full-text

1057 Outcome Reporting Following Rectopexy Requires Standardisation for Reproducibility and Transparent Outcome Analysis

British Journal of Surgery ◽

10.1093/bjs/znab259.418 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

H Wa Katolo ◽

C Fleming ◽

G Wilkinson ◽

A Brannigan

Keyword(s):

Quality Of Life ◽

Rectal Prolapse ◽

English Language ◽

Cleveland Clinic ◽

Outcome Analysis ◽

Incontinence Score ◽

Outcome Reporting ◽

Randomised Controlled ◽

The Impact

Abstract Aim Rectopexy is a surgical procedure commonly used to correct rectal prolapse. Several studies have investigated different approaches (abdominal, perineal) and techniques (open, laparoscopic, robotic) in this field however reporting outcomes vary significantly among studies impeding comparison of techniques. We aimed to comprehensively analyse primary outcome reporting methods following rectopexy in published literature. Method A systematic search was performed in keeping with PRISMA guidelines and search protocol registered with PROSPERO. Published databases were searched using the following terms: “rectopexy”, “abdominal rectopexy” and “rectopexy outcomes”. Randomised controlled trials, comparative and non-comparative prospective and retrospective studies published between 1992 and 2019 were included for analysis. Review articles, letters, editorials, abstracts, and non-English language studies were excluded. A narrative description of outcomes was reported. Results A total of 1089 articles were screened, and 32 articles were identified as suitable for inclusion, reporting on 1780 patients who underwent rectopexy surgery. Over 30 unique methods of reporting outcomes were recorded, with the most common being the rate of recurrence (n = 15), Cleveland Clinic Faecal Incontinence score (CCIS) (n = 11), and customised symptom questionnaires (n = 10). Many studies recognised the impact of symptoms of rectal prolapse on patients’ quality of life (QoL) however, few utilised standardised quality of life scores to evaluate the outcome of the procedures. Conclusions As surgical technique evolves in rectopexy, incorporating minimally invasive surgery and robotic surgery, it is important that outcome reporting is standardised to facilitate transparent comparison. Improving patient QoL is the mainstay of surgical intervention and it is important that QoL outcome measures are incorporated.

Download Full-text

PENDAMPINGAN UPAYA MENURUNKAN INKONTINENSIA URIN BAGI MASYARAKAT DI TALANG BETUTU PALEMBANG

JMM (Jurnal Masyarakat Mandiri) ◽

10.31764/jmm.v4i1.1753 ◽

2020 ◽

Vol 4 (1) ◽

pp. 77

Author(s):

Dheni Koerniawan ◽

Srimiyati Srimiyati ◽

Aniska Indah Fari ◽

Sanny Frisca ◽

Wendi Putra Pratama

Keyword(s):

Urinary Incontinence ◽

Community Service ◽

Coming Out ◽

The Elderly ◽

Pharmacological Therapy ◽

Incontinence Score ◽

Kegel Exercises ◽

Service Activities ◽

The Mean

Abstrak:Inkontinensia urine menjadi salah satu masalah yang meluas dan merugikan terutama bagi lansia. Salah satu bentuknya seperti lansia akan merasa rendah diri karena selalu basah akibat urine yang keluar, mungkin pada saat batuk, bersin, mengangkat barang berat dan ketidakmampuan menahan buang air kecil. Senam Kegel yang merupakan terapi non farmakologi untuk mengatasi inkontinensia urin. Kegiatan pengabdian yang dilakukan bertujuan untuk melatih lansia untuk melakukan senam Kegel sehingga dapat mengurangi gejala inkontinensia urin. Kegiatan dilakukan dengan pemberian edukasi, latihan senam Kegel, dan pendampingan selama tiga pertemuan. Hasil kegiatan menunjukkan bahwa mitra mengalami penurunan ketidakmampuan menahan kemih dari rerata 8,56 menjadi 6,3 dan penurunan frekuensi berkemih dari rerata 2,07 menjadi 1,44 serta rerata skor total inkontinensia urine menurun dari 10,63 menjadi 7,74. Abstract:Urinary incontinence is a widespread and detrimental problem especially for the elderly. One form such as the elderly will feel inferior because it is always wet due to urine coming out, maybe when coughing, sneezing, lifting heavy objects and the inability to resist urination. Kegel exercises which is a non-pharmacological therapy for overcoming urinary incontinence. Community service activities was aimed to train elderly for doing Kegel exercise thus can reduce symptoms of urinary incontinence. Service were carried out by providing education, Kegel exercises, and mentoring for three meetings. The results of the activity showed that the partners experienced a decrease in the inability to hold urine from an average of 8.56 to 6.3 and a decrease in the frequency of urination from a mean of 2.07 to 1.44 and the mean total urinary incontinence score decreased from 10.63 to 7.74Abstrak:Inkontinensia urine menjadi salah satu masalah yang meluas dan merugikan terutama bagi lansia. Salah satu bentuknya seperti lansia akan merasa rendah diri karena selalu basah akibat urine yang keluar, mungkin pada saat batuk, bersin, mengangkat barang berat dan ketidakmampuan menahan buang air kecil. Senam Kegel yang merupakan terapi non farmakologi untuk mengatasi inkontinensia urin. Kegiatan pengabdian yang dilakukan bertujuan untuk melatih lansia untuk melakukan senam Kegel sehingga dapat mengurangi gejala inkontinensia urin. Kegiatan dilakukan dengan pemberian edukasi, latihan senam Kegel, dan pendampingan selama tiga pertemuan. Hasil kegiatan menunjukkan bahwa mitra mengalami penurunan ketidakmampuan menahan kemih dari rerata 8,56 menjadi 6,3 dan penurunan frekuensi berkemih dari rerata 2,07 menjadi 1,44 serta rerata skor total inkontinensia urine menurun dari 10,63 menjadi 7,74. Kata kunci: Lansia; Inkontinensia urin; Senam Kegel Abstract:Urinary incontinence is a widespread and detrimental problem especially for the elderly. One form such as the elderly will feel inferior because it is always wet due to urine coming out, maybe when coughing, sneezing, lifting heavy objects and the inability to resist urination. Kegel exercises which is a non-pharmacological therapy for overcoming urinary incontinence. Community service activities was aimed to train elderly for doing Kegel exercise thus can reduce symptoms of urinary incontinence. Service were carried out by providing education, Kegel exercises, and mentoring for three meetings. The results of the activity showed that the partners experienced a decrease in the inability to hold urine from an average of 8.56 to 6.3 and a decrease in the frequency of urination from a mean of 2.07 to 1.44 and the mean total urinary incontinence score decreased from 10.63 to 7.74

Download Full-text

Assessment of judgment ability in a Brazilian sample of patients with mild cognitive impairment and dementia

Dementia & Neuropsychologia ◽

10.1590/1980-57642021dn15-020007 ◽

2021 ◽

Vol 15 (2) ◽

pp. 200-209

Author(s):

Patrícia Helena Figueirêdo do Vale-Britto ◽

Laura Rabin ◽

Livia Spindola ◽

Ricardo Nitrini ◽

Sonia Maria Dozzi Brucki

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Clinical Utility ◽

Area Under The Curve ◽

The Elderly ◽

Relevant Information ◽

Practical Judgment ◽

Brazilian Sample ◽

Everyday Problems

ABSTRACT. Judgment is the ability to make sound decisions after consideration of relevant information, possible solutions, likely outcomes, and contextual factors. Loss of judgment is common in patients with mild cognitive impairment (MCI) and dementia. The Test of Practical Judgment (TOP-J) evaluates practical judgment in adults and the elderly, with 15- and 9-item versions that require individuals to listen to scenarios about everyday problems and report their solutions. Objective: Adaptation of TOP-J for a Brazilian sample, preparation of a reduced version and verification of the accuracy of both. Methods: Eighty-five older adults, including 26 with MCI, 20 with Alzheimer’s disease (AD), 15 with frontotemporal dementia behavioral variant (FTDbv) and 24 controls, underwent neuropsychological assessment including the Brazilian adaptation of the TOP-J (TOP-J-Br). Results: On both TOP-J-Br versions, controls outperformed MCI, AD and FTDbv patients (p<0.001) and MCI outperformed AD and FTDbv (p<0.001). For the TOP-J/15-Br, the best cutoff for distinguishing controls and patients had a sensitivity of 91.7%, specificity of 59.0% and area under the curve of 0.8. For the TOP-J/9-Br, the best cutoff for distinguishing controls and patients had a sensitivity of 79.9%, specificity of 72.1% and area under the curve of 0.82. Conclusion: The TOP-J/15-Br, and particularly the TOP-J/9-Br, showed robust psychometric properties and the potential for clinical utility in Brazilian older adults at various stages of neurodegenerative cognitive decline.

Download Full-text