Geriatric Care
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2465-1397, 2465-1109

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Alberto Cella ◽  
Erica Volta ◽  
Jacopo Demurtas ◽  
Renato Zaccaria ◽  
Moira Ceci ◽  
...  

e-Health technologies may potentially improve healthcare assistance for frail elderly subjects. However, despite the interest and potential benefits of the field, research highlighted that several challenges remain, such as scarce wide spreading of information and communication technology technologies among the elderly and infrastructural difficulties. The aim of this survey was to assess to what extent digital technologies are widespread and used among Italian geriatricians. We conducted an online survey addressed to geriatricians, from the SIGOT (The Italian Geriatric Society) website, collecting the 78 completed questionnaires. We then analyzed with descriptive statistics the data. Results showed a still scarce use of digital technologies in geriatric practice in Italy. However, more than 60% of the SIGOT geriatricians who participated in the survey responded that the use of digital technology had increased significantly due to COVID-19 pandemic and for 80% of the members, the priority areas for the use of technologies for the care and treatment of the elderly are the management of chronic diseases and the prevention of hospitalization.


2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Arpita Debnath ◽  
Himadri Bhattacharjya

Growing life expectancy is challenging the quality of health care for elderly. Information regarding health related quality of life (QOL) may help policy makers to design need based health programs for this population. The objectives of this study were to estimate health related QOL of the geriatric population living in rural areas of West Tripura district and to compare it between ethnic and non-ethnic populations in respect to important domains. This community based cross-sectional study was conducted during 1st February 2019 to 31st March 2020 among 225 geriatric subjects of rural West Tripura district chosen by multistage sampling. World Health Organization’s QOL-BREF scale was used for data collection. Among the study population 46.2% had overall good health related QOL. About 52.9% had good QOL in environment and 37.3% had good QOL in social relationship domains. Marginally higher proportion of the subjects from ethnic origin had better QOL than the non-ethnic but it was not significant. Higher proportion of the Muslim subjects had better QOL than the rest, but it was also not significant. Bivariate analysis showed significant associations of QOL with age, sex, literacy, financial condition, socioeconomic status and type of family. Multivariate analysis identified male sex, younger age and living with spouse as significant predictors of good QOL. Overall health related QOL of the geriatric people living in rural areas of West Tripura district is poor but younger male subjects, of ethnic origin and living with spouse may enjoy relatively better QOL.


2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Manish Keshwani ◽  
Habib Md Reazaul Karim ◽  
Suresh Nagalikar ◽  
Deepak Kumar Biswal ◽  
Samarjit Dey

Hyponatremia is a common electrolyte disorder, especially in the frail elderly population. With the increasing number of surgeries in the aging population, hyponatremia is frequently encountered by anesthesiologists and surgeons. Unfortunately, management of hyponatremia is often complex in the elderly population as it is often multifactorial, and they are physiologically susceptible. While it is well known that preoperative hyponatremia is associated with increased perioperative morbidity and mortality, a lack of recommendations or guidelines adds to the dilemma in managing such cases. The most common cause of chronic hyponatremia in the elderly is the syndrome of inappropriate antidiuretic hormone (SIADH), which can be resistant to conventional treatment. On the other hand, paraneoplastic SIADH leading to hyponatremia is rare, and surgery may be the only option available for its correction. We present a case of a 78- years-gentleman to highlight such a dilemma. He was diagnosed with renal cell carcinoma and had chronic refractory severe hyponatremia despite treatment with fluid restriction, low dose hydrocortisone, tolvaptan, and 3% sodium chloride.


2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Maria Bonvicini ◽  
Davide Crapanzano ◽  
Susanna Fenu ◽  
Marco Giordano ◽  
Lorenzo Palleschi

We present an eighty-year old man with a one year history of progressive macroglossia, dysphagia and loss of weight. He had a medical history of arterial hypertension and prostatic hypertrophy which he had under good therapeutic control. The entire tongue was swollen, had hard solidity and was slightly painful upon palpation. A tongue biopsy revealed an amyloid deposition as it coloured bright orange-red on Congo Red staining and lead us subsequently to the diagnosis of amyloidosis; then a bone marrow biopsy confirmed the diagnosis of multiple myeloma. The case was further evaluated by a multidisciplinary team who considered it appropriate to start a lowdose melphalan treatment combined with supportive care. When macroglossia in the tongue is confirmed to be amyloidosis the differential diagnosis should include systemic amyloidosis deposition and multiple myeloma.


2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Sweta Nariya ◽  
Ajita Pillai ◽  
Sneha Agravat

People above 65 years of age would amount to 10.7% of total population of India by 2021. India has acquired the label of ‘an ageing nation’ with 7.7% of its population being more than 60 years old. Geriatric patients are exposed to potentially inappropriate medications (PIMs) thus strategies to improve quality of life and safety of prescribing is needed. One such explicit criteria tool is ‘Screening Tool of Older person’s Potentially inappropriate Prescriptions’ (STOPP) criteria. For older individuals, frailty plays a decisive role. Frailty assessment is useful for identification of risk stratifications to assist in clinical decision makings. Hence, this study is aimed to assess the percentage of PIM using STOPP criteria and correlation between PIMS and Frailty Index (FI) in elderly patients in our setting. An observational study was done in 60 patients in department of medicine at tertiary care teaching hospital. Demographic details, diagnosis and current medications were recorded in Microsoft excel 2016. PIMs based on STOPP criteria version 2 and FI suggested by Searle et al. was calculated and analyzed. Spearman rank correlation test was used to check the correlation between FI and PIM. Out of 60 prescriptions, 21 prescriptions with PIM were found. Most common drugs prescribed as PIM were Aspirin, calcium, ceftriaxone, multivitamin B complex and furosemide. FI was analyzed by using 34 variables. Value of FI was between 0.03 to 0.17. Spearman Rank correlation test showed direct low degree of significant correlation between FI and PIM with correlation (r) value of 0.1602 (P value=0.02). 35% of prescriptions were having at least one PIM in our study and we found that there was direct association between FI and PIM which will help us to reduce potential medication errors, drug interactions and adverse reactions.


2021 ◽  
Vol 7 (3) ◽  
Author(s):  
The COMEPA group

Coronavirus disease 2019 (COVID-19) has dramatically changed our lives. In the past months, hospitals were saturated of patients; therefore, it is still important to have simple and standardized prognostic factors and to evaluate the efficacy and safety of medications commonly used for COVID-19. We aimed to collect data of the patients hospitalized in Internal Medicine and Geriatrics Wards at the University Hospital (Policlinico) ‘P. Giaccone’ in Palermo, Italy (COMEPA, COVID-19 Medicina Policlinico Palermo), with the main purpose of finding prognostic tools that can be easily used in clinical practice in order to identify patients hospitalized for/with COVID-19 at higher risk of negative outcomes, such as mortality, transfer to Intensive Care Unit (ICU) and institutionalization, as well as evaluating the efficacy/safety of medications commonly used for COVID-19. For reaching these aims, the medical records of approximately 600 patients will be recorded, having data on several parameters and including as outcomes mortality, ICU placement, institutionalization. With the COMEPA study, we therefore plan to update current literature, giving new data on prognostic factors and on the efficacy/safety of some medications used for COVID-19.


2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Franziska M. Müller ◽  
Anna M. Meyer ◽  
Lena Pickert ◽  
Annika Heeß ◽  
Ingrid Becker ◽  
...  

Older persons often loose independence during hospitalization. This analysis aimed at retrospectively evaluating the effects of a pilot individualized multidimensional intervention (IMI) on the comprehensive geriatric assessment (CGA)-based prognosis of older multimorbid patients in an acute internal medicine setting. Records from 72 patients aged 65 years and above who received the IMI were compared to those from 403 patients who received standard of care (SOC). All patients had undergone the CGA-based Multidimensional Prognostic Index (MPI) calculation on admission and at discharge. Patients were divided into three risk groups according to MPI score: Low-risk (MPI-1, 0-0.33), medium-risk (MPI-2, 0.34-0.66) and high-risk (MPI-3, 0.67-1). From admission to discharge, IMI patients showed significant improvements in their MPI score (P=0.014) and subdomains compared to SOC. This was particularly evident in MPI-2 and MPI-3 as well as in patients with poorer functions on MPI admission subdomains. An early geriatric intervention during hospitalization for disease-specific treatments in internal medicine settings improves overall individual prognosis in older multimorbid patients. Prospective randomized studies are needed to confirm these preliminary retrospective observations.


2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Siukan Law ◽  
Albert Wingnang Leung ◽  
Chuanshan Xu

Yoga is possible for elderly care as it promotes and balance among mind–brainbody functions through mental, physical, and emotional practices. Growing evidence has shown that yoga practices strengthen muscle, body flexibility, and boost the immune system as well as improve the physical and psychological conditions.


2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Mirko Di Capua ◽  
Alessio Conca ◽  
Simone Testa ◽  
Maria Mascolo ◽  
Stefano Paglia

Severe acute respiratory syndromerelated coronavirus 2 (SARS-CoV-2) infection has spread worldwide. The most of patients presents fever, dyspnea and cough as a typical viral infection, others show peculiar clinical and laboratory signs, such as anosmia, ageusia and thrombocytopenia. We here describe a severe coronavirus disease 2019 patient (76-year old, male) that developed an immune thrombocytopenia and acquired pseudo-thrombocytopenia that were refractory to immunomodulators even after resolution of respiratory failure. The patient developed thrombocytopenia (platelets 88,000/mm3) that got worse the following day (14,000/mm3). We started 1 mg/kg of methylprednisolone i.v. daily. Platelet count increased up to 209,000/mm3, in sodium citrate, but remained about 14,000/mm3 in EDTA 10 days after the beginning of methylprednisolone. The patient showed great improvement in respiratory parameters and radiological finding. About one week after he developed a thrombocytopenia up to 70,000/mm3. We did not modify the steroids dosage. Platelet count slowly began to increase and in about 10 days returned to normal values.


2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Liliana Mazza ◽  
Riccardo Ievoli

The evaluation and measurement of Sustainable Development and Well-being represent a widespread emerging theme in healthcare, especially concerning, among others, the concepts of social equity and universality of health from an intergenerational perspective. To achieve such goals, Geriatrics would play a prominent role, especially considering the growing portion of the senior population in developed countries. This work intends to explore the possibility to connect Sustainable Development Goals and dimensions of Well-being to a set of performance indicators which are representative of geriatric activities in different settings of care. To this purpose, a pattern of indicators from Emilia- Romagna Region (RER) in Italy is considered. Furthermore, a range of Transitional Care interventions is discussed and proposed in order to ameliorate (or keep stable) the performance.


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