The Comparison of the Dietary Intake Loss Between Elderly and Non-Elderly Patients After Gastrectomy for Gastric Cancer

Background/Aim The present study quantified the changes in the dietary and nutritional intake after gastrectomy between elderly and non-elderly patients. Patients and Methods This prospective observational study enrolled patients who underwent curative gastrectomy for gastric cancer. Results Twenty-three patients ≥ 75 years old were classified into the elderly group, and 127 patients < 75 years old were classified into the non-elderly group. The respective median % dietary intake losses at 1 and 3 months postoperatively were −12.4% and −5.3% in the elderly group and −8.3% and −2.8% in the non-elderly group (p = 0.075 and 0.080). On comparing the intake loss of three major nutrients, the respective median % lipid intake losses at 1 and 3 months postoperatively were −13.5% and −5.8% in the elderly group and −7.3% and 0% in the non-elderly group (p = 0.029 and 0.045). Conclusion Our results suggested that elderly patients experienced more serious lipid intake loss after gastrectomy than non-elderly patients.

Analysis of Clinicopathological Features and Risk Factors for Severe Complications after Gastrectomy for Gastric Cancer in Elderly Patients

Objective: As life expectancy is increasing, the number and proportion of elderly patients with gastric cancer are also expanded. This study aimed to investigate the clinicopathological features for elderly gastric cancer patients undergoing gastrectomy and analyze risk factors for developing severe complications.Methods: A total of 514 patients treated surgically for gastric cancer between January 2016 and December 2019 were enrolled in this retrospective study. Patients were divided into two groups: younger group ( ≤ 69 years) and elderly group ( ≥ 70 years). Clinicopathological characteristics and operative outcomes including the complications and mortality were compared between two groups. Risk factors for severe complications in elderly gastric cancer patients were also investigated.Results: Of the 514 patients, 145 (28.2%) were elderly group. Comorbidity (P < 0.001), differentiated histology (P = -0.006), deeper in tumor depth (P = 0.012), and frequent lymph node metastasis (P = 0.028) were observed in elderly group. Overall complications (P = 0.046) and severe complications (P = 0.049) were significantly higher in elderly group. Multivariate analysis indicated that extent of resection (P = 0.044) was associated with severe complications in elderly gastric cancer patients.Conclusion: Elderly patients have a significantly higher probability of complications and severe complications than younger patients after gastrectomy for gastric cancer. Especially, when total gastrectomy was performed in elderly gastric cancer patients, the risk of developing serious complications was significantly higher more than 3 times. Therefore, surgeons should pay attention to gastric cancer patients over the age of 70 who require total gastrectomy.

Differences in Preoperative Gastric Ultrasound Findings Between Old and Young Surgical Patients: A Retrospective Case-Control Study

Background: Most gastric ultrasound studies have been conducted in young middle-aged patients. Although age is known to influence gastric ultrasound, comparisons of gastric ultrasound in elderly patients with young patients have not been well elucidated. This study aimed to 1) compare gastric ultrasound assessments between young and elderly patients, 2) determine whether the CSA cutoff values for elderly and young patients should be different, and 3) suggest CSA cutoff values for elderly patients.Methods: This retrospective case-control study evaluated the data of 120 patients who underwent elective surgery under general anesthesia between July 2019 and August 2020. Demographic and gastric ultrasound assessment data were retrieved. Patients were divided into the elderly group (n = 58, age: ≥65 years) and young group (n = 62, age: <65 years). The antral cross-sectional area (CSA) in the supine and right lateral decubitus positions (RLDP), semiquantitative three-point Perlas grade (grades 0, 1, and 2), and gastric volume were determined. CSAs according to different Perlas grades were compared between the two groups. The CSA cutoff values for predicting a high risk of pulmonary aspiration in both the groups were determined. Results: Among patients with Perlas grade 0 (empty stomach), the CSA supine and CSA RLDP were greater in the elderly group than in the young group (CSA supine: 5.12 ± 1.99 cm2 vs. 3.92 ± 0.19 cm2, P = 0.002, and CSA RLDP: 6.24 ± 0.43 cm2 vs. 4.58 ± 0.21 cm2, P = 0.002). The specificity, positive predictive value, and accuracy of the CSA decreased when the CSA cutoff value for the young group (CSA RLDP: 6.92 cm2) was applied to the elderly group. The CSA cutoff values for the elderly group were: CSA supine, 6.92 cm2 and CSA RLDP, 10.65 cm2.Conclusions: The CSA of the empty stomach was greater in elderly patients than in young patients. The CSA cutoff values for predicting pulmonary aspiration risk in elderly and young patients should be differentiated. We suggest that the following CSA cutoff values should be used for predicting pulmonary aspiration risk in elderly patients: CSA supine, 6.92 cm2 and CSA RLDP, 10.65 cm2.

Perancangan Antarmuka Berdasarkan Evaluasi Usabilitas Penggunaan Aplikasi KlikDokter Untuk Pralansia dan Lansia

The situation and condition of the spread of Covid-19 in Indonesia have forced everyone to reduce the intensity of going out of the house, including activities related to the need for health services. Therefore, a solution is needed so that people can meet their health needs without leaving the house. Taking into account that the elderly as the community group that is most vulnerable to contracting the virus and has the highest mortality rate, it can be said that the elderly is the group of people who most need online health services. Along with the growing penetration of internet usage and the increasing number of smartphone ownership in Indonesia, m-health is the right choice to help people access health services online via smartphones. KlikDokter is an example of m-health or a mobile-based application that provides various online health services. However, it was found that there were complaints that the KlikDokter application was too complicated and difficult for the elderly to use. From this problem, a usability test was finally carried out on the KlikDokter application interface, to identify what interface elements in the KlikDokter application were difficult for elderly users. The research respondents were divided into two groups with 16 and 17 people respectively. The first group is the elderly group aged >60 years. And the second group is the pre-elderly group with ages between 45 to 59 years. A pre-elderly group is a comparison group (control group). This test is carried out by measuring several aspects of usability, namely effectiveness, efficiency, user satisfaction, error, and cognitive load.

Nutritional Status and Serum Levels of Micronutrients in an Elderly Group Who Participate in the Program for Complementary Food in Older People (PACAM) from the Metropolitan Region, Santiago de Chile

The increase in the Chilean elderly population has promoted public policies to favor an adequate nutrition in later life. This study evaluated the nutritional status, micronutrients intake and serum micronutrients levels of an elderly group beneficiary of the PACAM from the Metropolitan Region, Santiago de Chile. Anthropometric and dietary survey (24 h food recalls) were assessed in 182 elderly individuals (60 and 80 years old). Blood serum collection was used to measure the micronutrient status. The sample was comprised by 12.6, 46.1, 28.0 and 13.2% of underweight, normal weight, overweight and obese subjects, respectively. Women presented 11% of underweight, 45% of normal weight and 44% of overweight and obese, while men—18, 50 and 32%, respectively. Only the 63% of the elderlies consumed PACAM foods, reaching average daily intakes below (50%) the recommended daily serving. Serum deficiencies of 25-hydroxyvitamin D (88%), vitamin B12 (33%) and calcium (36%) were observed, being the highest ones in the PACAM foods women (60–75 years old). Chilean elderlies presented mainly a normal weight; however, an important proportion of overweight/obese subjects was observed. Although PACAM foods consumption significantly increased the micronutrient intake, it was not enough to ensure an adequate serum micronutrient levels in the elderly.

ANALISIS KADAR C-REACTIVE PROTEIN PADA PASIEN LANJUT USIA DENGAN KOMORBID YANG TERKONFIRMASI POSITIF COVID-19 DI RSUD PASAR REBO

Coronavirus Disease 2019 (COVID-19) is a disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Severe cases of SARS-CoV-2 infection are characterized by a systemic inflammatory response in acute respiration. The inflammatory response can be checked by laboratory tests with C-Reactive Protein. The purpose of this study was to determine CRP levels in elderly patients with comorbidities who were confirmed positive for Covid-19. This type of research is descriptive quantitative with a cross-sectional design using accidental sampling technique obtained a sample of 56 patients. This research was conducted at Pasar Rebo Hospital. Based on the univariate statistical test, the frequency distribution of males was 29 people (51.8%) while women were 27 people (48.2%), the elderly group with the highest group was in the elderly group with an age range of 65-69 years as many as 22 people (39.3%), elderly patients with comorbid Hypertension dominate as many as 18 people (32.1%). The results of laboratory examinations showed an increase in levels of C-Reactive Protein which varied, this was accompanied by the condition of patients who had clinical comorbidities. Covid-19 in the elderly also worsens the symptoms and course of Covid-19, due to decreased immune function, the immune system of organs and the many clinical comorbidities that occur.

Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study

Objective: We aimed to compare the outcomes and safety of chemoradiotherapy (CRT) between elderly and non-elderly patients with head and neck squamous cell carcinoma (HNSCC). It is difficult to assess the causal effect of age because of possible differences in general conditions among individuals. Therefore, we adjusted the background factors of elderly and non-elderly patients using propensity score matching (PSM).Methods: A total of 146 patients with HNSCC who received CRT were divided into an elderly (≥70 years, n = 35) and non-elderly group (&lt;70 years, n = 111). Pre-treatment characteristics, including the performance status, Charlson comorbidity index, body mass index, primary site, and TNM stage were adjusted by PSM. We compared the outcomes and safety of CRT with high-dose single-agent cisplatin (CDDP) as well as outcomes following recurrence between the groups, before and after PSM.Results: The total dose of CDDP administered during CRT was significantly lower in the elderly group before PSM. However, it became comparable to the non-elderly group and adverse events did not differ between the groups following PSM, resulting in a comparable CRT completion rate. Overall-, disease specific-, and progression-free survivals of elderly patients were comparable to those of non-elderly patients following PSM. In contrast, elderly patients with recurrence could receive fewer salvage treatments than their non-elderly counterparts, resulting in worse survival.Conclusions: CRT with high-dose CDDP is safe and effective for the treatment of elderly patients with HNSCC. However, salvage treatments can be rarely conducted for elderly patients with a recurrence, considering a deterioration of their general condition.

The Comparison of the Dietary Intake Loss Between Elderly and Non-elderly Patients after Gastrectomy for Gastric Cancer

Background/Aim: The present study quantified the changes in the dietary and nutritional intake after gastrectomy between elderly and non-elderly patients. Patients and Methods: This prospective observational study enrolled patients who underwent curative gastrectomy for gastric cancer. Results: 23 patients ≥75 years old were classified into the elderly group, and127 patients <75 years old were classified into the non-elderly group. The respective median % dietary intake losses at one and three months postoperatively were -12.4% and -5.3% in the elderly group and -8.3% and -2.8% in the non-elderly group (p=0.075 and 0.080). On comparing the intake loss of three major nutrients, the respective median % lipid intake losses at 1 and 3 months postoperatively were -13.5% and -5.8% in the elderly group and -7.3% and 0% in the non-elderly group (p=0.029 and 0.045). Conclusion: Our results suggested that elderly patients experienced more serious lipid intake loss after gastrectomy than non-elderly patients.