scholarly journals Nutrition and malnutrition in elderly patients

2013 ◽  
pp. 99-104
Author(s):  
Daniela Tozzuoli ◽  
Emanuele Ceccherini ◽  
Claudio Pedace
Keyword(s):  
Elderly Patients ◽  
Nutritional Support ◽  
Adverse Outcomes ◽  
Patient Specific ◽  
Artificial Nutrition ◽  
Oral Supplementation ◽  
Protein Energy ◽  
Age Related ◽  
Clinical Conditions ◽  
Underlying Diseases

Protein-energy undernutrition is a very common problem among elderly patients. It is promoted by age-related decreases in the basal metabolic rate, physiological change in body composition, progressive dysphagia, physical and/or cognitive impairments, depression, socioeconomic factors, effects of drugs on absorption and utilization of nutrients, and other factors. Several studies suggest that nutritional support can lower the risk of adverse outcomes among undernourished elderly patients. Monitoring food intake in patients with dysphagia may be useful in deciding between oral supplementation or artificial nutrition. The decision to provide nutritional support and the route to be used will depend on the clinical conditions of the patient, the severity of the dysphagia, the expected course of any underlying diseases, and several other patient-specific considerations. In geriatric patients, the main objectives of this type of therapy are usually the maintenance of function and improvement of the quality of life.

scholarly journals Malnutrition in pediatric practice: differential diagnosis and possibilities for nutritional support

2019 ◽  
pp. 200-208 ◽  
Author(s):  
I. N. Zakharova ◽  
Yu. A. Dmitrieva ◽  
N. G. Sugyan ◽  
M. A. Simakova
Keyword(s):  
Differential Diagnosis ◽  
Nutritional Support ◽  
Normal Growth ◽  
Adverse Outcomes ◽  
Energy Deficiency ◽  
Protein Energy ◽  
Increased Risk ◽  
Nutrient Reserves

Nutrition is of great importance in maintaining normal growth and development of the child, ensuring the ability to learn and resistance to adverse environmental factors. Due to the higher need for nutrients, limited nutrient reserves, and particular characteristics of metabolic processes, children are more prone to the development of various nutritional disorders, in particular, protein and energy deficiency. The nutritional factor becomes of great importance on the background of the accompanying acute and chronic diseases in children. The studies convincingly demonstrated that malnutrition leads to a prolongation of hospital stay, increased frequency of complications and increased risk of adverse outcomes. Therefore, timely diagnosis of nutritional disorders is an essential factor in maintaining health and improving the children’s quality of life. The article presents the current classification of malnutritiion, illustrates the main stages of the anthropometric examination, identifies approaches to the differential diagnosis of protein-energy deficiency causes, and discusses the possibilities of nutritional support using specialized mixtures.

From nutritional screening to assessment and nutritional planning in community, acute, and long-term care

2017 ◽  
pp. 479-486
Author(s):  
Gianfranco Gioia ◽  
Alessio Molfino ◽  
Filippo Rossi Fanelli ◽  
Maurizio Muscaritoli
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Screening Tools ◽  
Care Process ◽  
Artificial Nutrition ◽  
Nutritional Screening ◽  
Term Care ◽  
Protein Energy ◽  
Age Related

Age-related malnutrition is the result of age-related metabolic derangements. Sarcopenia in older people is also the result of malnutrition-related metabolic changes determining the lack of long-term muscle anabolic response to nutrient intake. Frailty is associated with the presence of nutritional derangements. Nutritional screening tools and nutritional assessment in ageing take into account diagnostic parameters for detecting the risk or the presence of protein-energy malnutrition in its different forms and stages. Nutritional screening represents the first step in the nutritional care process. A full nutritional assessment is necessary if the risk of malnutrition is detected during a nutritional screening. Nutritional and metabolic interventions are recommended for all those patients identified by screening and assessment as at risk for malnutrition or malnourishment. Nutritional plans offer several options to the patients according to the clinical setting (i.e. nutritional counselling, food fortification, oral nutritional supplements, and artificial nutrition).

SELECTIVE LASER TRABECULOPLASTY IN ELDERLY PATIENTS WITH ADVANCED OPHTHALMOPATHOLOGY

2020 ◽  
pp. 97-103
Author(s):  
Лия Шамильевна Рамазанова ◽  
Татьяна Игоревна Субботина ◽  
Павел Львович Володин ◽  
Кристина Феликсовона Макконен ◽  
Владимир Александрович Мачехин ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
The Elderly ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
Results Of Treatment ◽  
Age Related ◽  
Clinical Conditions

В пожилом возрасте сочетание первичной открытоугольной глаукомы с катарактой представляет актуальную медико-социальную проблему и требует новых методов лечения. Цель исследования - анализ результатов лечения у пациентов с далекозашедшей первичной открытоугольной глаукомы и возрастной катарактой методом селективной лазерной трабекулопластики. В клинических условиях проведена селективная лазерная трабекулопластика 24 пациентам пожилого возраста с сочетанной первичной открытоугольной глаукомой и катарактой. При оценке результатов лечения изучались морфометрические и функциональные показатели зрительных функций общепринятыми в офтальмологической практике методами. Установлено, что селективная лазерная трабеклопластика снижает внутриглазное давление и стабилизирует глаукомный процесс. Использованный метод лечения сочетанной первичной открытоугольной глаукомы с катарактой обеспечивает достоверное уменьшение объёма глобальных потерь, увеличение толщины хориоидеи перипапиллярной и фовеальной области, суммы полей зрения. Поэтому данный метод селективной лазерной трабекулопластики следует активно применять у пациентов с первичной открытоугольной глаукомой и катарактой в пожилом возрасте In old age, the combination of primary open-angle glaucoma with cataract is an urgent medical and social problem and requires new methods of treatment. The aim of the study was to analyze the results of treatment in patients with far-advanced primary open-angle glaucoma and age-related cataracts using selective laser trabeculoplasty. In clinical conditions, selective laser trabeculoplasty was performed in 24 elderly patients with combined primary open-angle glaucoma and cataracts. When evaluating the results of treatment, morphometric and functional indicators of visual functions were studied using methods generally accepted in ophthalmological practice. It was found that selective laser trabeculoplasty reduces intraocular pressure and stabilizes the glaucoma process. The used method of treatment of combined primary open-angle glaucoma with cataract provides a significant reduction in the volume of global losses, an increase in the thickness of the choroid of the peripapillary and foveal regions, and the sum of the fields of vision. Therefore, this method of selective laser trabeculoplasty should be actively used in patients with primary open-angle glaucoma and cataracts in the elderly

scholarly journals Genetic biomarkers in the VEGF pathway predicting response to anti-VEGF therapy in age-related macular degeneration

2019 ◽  
Vol 4 (1) ◽  
pp. e000273
Author(s):  
Irina Balikova ◽  
Laurence Postelmans ◽  
Brigitte Pasteels ◽  
Pascale Coquelet ◽  
Janet Catherine ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Treatment Response ◽  
Multiple Testing ◽  
Age Related Macular Degeneration ◽  
Patient Specific ◽  
Multiple Testing Correction ◽  
Anti Vegf ◽  
Age Related ◽  
Vegf Pathway

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.

scholarly journals Brain Tumor Resection in Elderly Patients: Potential Factors of Postoperative Worsening in a Predictive Outcome Model

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2320
Author(s):  
Paolo Ferroli ◽  
Ignazio Gaspare Vetrano ◽  
Silvia Schiavolin ◽  
Francesco Acerbi ◽  
Costanza Maria Zattra ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Performance Status ◽  
Tumor Resection ◽  
Patient Specific ◽  
Invasive Treatment ◽  
Tertiary Referral Center ◽  
Surgical Complexity

The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in elderly patients. Therefore, all patients ≥65 years old who underwent BT resection at a tertiary referral center between 01/2018 and 12/2019 were included. Age, smoking, previous radiotherapy, hypertension, preoperative functional status, complications occurrence, surgical complexity and the presence of comorbidities were prospectively collected and analyzed at discharge and the 3-month follow-up. The series included 143 patients (mean 71 years, range 65–86). Sixty-five patients (46%) had at least one neurosurgical complication, whereas 48/65 (74%) complications did not require invasive treatment. Forty-two patients (29.4%) worsened at discharge; these patients had a greater number of complications compared to patients with unchanged/improved performance status. A persistent worsening at three months of follow-up was noted in 20.3% of patients; again, this subgroup presented more complications than patients who remained equal or improved. Therefore, postoperative complications and surgical complexity seem to influence significantly the early outcome in elderly patients undergoing brain tumor surgery. In contrast, postoperative complications alone are the only factor with an impact on the 3-month follow-up.

scholarly journals Crack Propagation in the Tibia Bone within Total Knee Replacement Using the eXtended Finite Element Method

2021 ◽  
Vol 11 (10) ◽  
pp. 4435
Author(s):  
Ho-Quang NGUYEN ◽  
Trieu-Nhat-Thanh NGUYEN ◽  
Thinh-Quy-Duc PHAM ◽  
Van-Dung NGUYEN ◽  
Xuan Van TRAN ◽  
...  
Keyword(s):  
Fatigue Crack ◽  
Crack Initiation ◽  
Crack Propagation ◽  
Fatigue Crack Initiation ◽  
Fracture Prevention ◽  
Patient Specific ◽  
Extended Finite Element ◽  
Tibia Bone ◽  
Age Related ◽  
Final Failure

Understanding of fracture mechanics of the human knee structures within total knee replacement (TKR) allows a better decision support for bone fracture prevention. Numerous studies addressed these complex injuries involving the femur bones but the full macro-crack propagation from crack initiation to final failure and age-related effects on the tibia bone were not extensively studied. The present study aimed to develop a patient-specific model of the human tibia bone and the associated TKR implant, to study fatigue and fracture behaviors under physiological and pathological (i.e., age-related effect) conditions. Computed tomography (CT) data were used to develop a patient-specific computational model of the human tibia bone (cortical and cancellous) and associated implants. First, segmentation and 3D-reconstruction of the geometrical models of the tibia and implant were performed. Then, meshes were generated. The locations of crack initiation were identified using the clinical observation and the fatigue crack initiation model. Then, the propagation of the crack in the bone until final failure was investigated using the eXtended finite element method (X-FEM). Finally, the obtained outcomes were analyzed and evaluated to investigate the age-effects on the crack propagation behaviors of the bone. For fatigue crack initiation analysis, the stress amplitude–life S–N curve witnessed a decrease with increasing age. The maximal stress concentration caused by cyclic loading resulted in the weakening of the tibia bone under TKR. For fatigue crack propagation analysis, regarding simulation with the implant, the stress intensity factorand the energy release rate tended to decrease, as compared to the tibia model without the implant, from 0.152.5 to 0.111.9 (MPa) and from 10240 to 5133 (J), respectively. This led to the drop in crack propagation speed. This study provided, for the first time, a detailed view on the full crack path from crack initiation to final failure of the tibia bone within the TKR implant. The obtained outcomes also suggested that age (i.e., bone strength) also plays an important role in tibia crack and bone fracture. In perspective, patient-specific bone properties and dynamic loadings (e.g., during walking or running) are incorporated to provide objective and quantitative indicators for crack and fracture prevention, during daily activities.

PP030 BODY WEIGHT INCREASES AFTER TRANSMURAL NUTRITIONAL SUPPORT IN MALNOURISHED ELDERLY PATIENTS

2010 ◽  
Vol 5 (2) ◽  
pp. 34-35
Author(s):  
F. Neelemaat ◽  
J.E. Bosmans ◽  
A. Thijs ◽  
J.C. Seidell ◽  
M.A. van Bokhorst-de van der Schueren
Keyword(s):  
Body Weight ◽  
Elderly Patients ◽  
Nutritional Support

Aging of Competitive Athletes

Gerontology ◽  
2017 ◽  
Vol 63 (5) ◽  
pp. 488-494 ◽  
Author(s):  
Hirofumi Tanaka
Keyword(s):  
Older Adults ◽  
Poor Quality ◽  
Negative Stereotypes ◽  
Age Related ◽  
Masters Athletes ◽  
Competitive Athletes ◽  
Vascular Stiffening ◽  
High Motivation ◽  
Clinical Conditions

Demographics of human aging are rapidly changing. As illustrated in the biomedicalization of aging, an ever increasing number of older adults is affected by a variety of clinical conditions and diseases, including vascular stiffening, sarcopenia, physical disability, and poor quality of life. One population that is situated in the opposite end of the health and functional spectrum to the sedentary frail elderly is Masters athletes. These older competitive athletes are endowed with substantial functional capacity, overall long-term health, high motivation, and psychosocial outlook. Masters athletes are combating the dogma and negative stereotypes of older adults and aging. From the scientific standpoint, examining Masters athletes can provide insight into preventive gerontology, primary prevention of age-related diseases and dysfunctions, and exercise-based medical practices. Moreover, the study on Masters athletes is simply joyous and entertaining as they often remind us what can be possible in aging.

scholarly journals Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski
Keyword(s):  
Drug Therapy ◽  
Adverse Effects ◽  
Elderly Patients ◽  
Regional Anesthesia ◽  
Pain Control ◽  
The Elderly ◽  
Surgical Patient ◽  
Cochrane Central Register ◽  
Promising Alternative ◽  
Age Related

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.

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