Most common cardiovascular diseases of the elderly – A review article

Number of people over 65 years is continuously increasing and represents an ever growing proportion of population even in Hungary. Medical treatment of the elderly implies a massive burden for the healthcare system. Special knowledge is required to provide an appropriate medical care for the elderly. During the ageing process, several changes accumulate in the body and several chronic diseases develop. Function of parenchymal organs is impaired, healing process is slower, clinical manifestations of diseases are not so prominent, the diagnosis is often difficult to establish. Moreover, treatment possibilities also differ, because pharmacokinetics and pharmacodynamics of drugs are different from that of young patients. Communication with older patients is also cumbersome, participation of a relative or caregiver at consultation can be useful. Cardiovascular diseases remain the leading cause of death of adults over the age of 65. Among these diseases congestive heart failure, coronary artery diseases, hypertension, atrial fibrillation have the greatest significance.

Ageing societies and the first and second waves of the COVID-19 pandemic – Statements of the European Geriatric Medicine Society and measures of the Hungarian Government concerning older people

Purpose Ageing of the societies is a demographic phenomenon in the developed world. SARS-CoV-2 is a novel human coronavirus responsible for a pandemic of coronavirus disease 2019 (COVID-19). World Health Organization (WHO) data demonstrated that the first two waves of the pandemic had the most severe impact on older people and that is why new guidelines and protocols were necessary in geriatric medicine to protect senior citizens. Materials and methods In our publication, we summarise the three statements of EuGMS concerning the first and second waves of COVID-19 pandemic in Europe. Besides following the European recommendations, a proper local response was necessary in each country. Results The Hungarian Government has successfully completed the necessary measures during the first two waves, which are summarised in our publication. Those measures took into consideration not only the international guidelines, but the capacities of the healthcare system, as well as the sociodemographic and economic characteristics of the country. Conclusions Successful local defence against COVID-19 required adequate and optimised interpretation of the international guidelines to save the life of thousands of older adults in Hungary.

Menopause and its management: A review

Menopausal transition (premenopause) is the phase in the ageing process of women representing the transition from the reproductive stage of life to the non-reproductive stage. With improvements in average life expectancy, women live an increased proportion of their lives in the postmenopause. The consequences of oestrogen loss are the early symptoms (psychological and vasomotor), the genitourinary syndrome (intermediate), as well as postmenopausal osteoporosis with increased risk of fractures and cardiovascular diseases (late). The diagnosis of climacteric syndrome is based on typical clinical symptoms. Perimenopausal women should understand physiological changes occurring in menopausal transition. They should be encouraged to live a healthy lifestyle. Menopausal hormone therapy is indicated for relief of the acute symptoms of menopause and for treatment of urogenital atrophy. It should be administered in the lowest effective dose for the shortest period of time. The treatment should be initiated before the age of 60 years or within 10 years after menopause in order to decrease its risks. The benefit/risk profile needs to be individually re-assessed every year.

Characteristics of the ageing skin, xerosis cutis and its complications

People in the developed countries are living longer. Geriatric dermatology is playing an increasingly important role as chances of developing skin-related problems increase with their ageing. Skin ageing is induced by two main processes: intrinsic and extrinsic. Extrinsic ageing is caused by environmental factors such as sun exposure, smoking, alcohol consumption, air pollution, and poor nutrition. Intrinsic ageing reflects the genetic background and depends on time. The aged skin is characterised by the appearance of dryness, atrophy, wrinkles, pigmented lesions, patchy hypopigmentation, and elastosis. This article provides an overview of skin ageing processes and common conditions found in the elderly persons such as xerosis, pruritus, and eczema.

Effects of ageing on the eyes

With ageing, significant changes occur in all structures of the eye, resulting in a variety of morphological and functional effects. This review summarises parameters that are within the normal ageing process in order to distinguish them from true disease processes. Understanding the ageing changes of the eye will help to understand some of the visual problems experienced by the ageing population.

Ageing and ocular problems

Ageing is a common problem in modern societies. Due to sophisticated new methods in medicine, the average life expectancy significantly increased in recent years. 70 is the new 50. The new principles of food intake and processing, more exercise, and less smoking contributed to a health benefits and a longer life span of human kind. Nevertheless, there are the special problems of ageing. Numerous dysfunctions of the body may arise affecting a broad range of organs and the musculoskeletal system. The eye can also be severely affected by ageing. Vision gained more importance recently especially during the COVID-19 pandemic. Elderly people who never used computers before, had to learn computer technology in order to communicate with their family and to accomplish their everyday tasks or pay their bills. Therefore, good near vision has become crucial for elderly people. In this review article the most common ageing problems of the eye, therapies and pathophysiology of ageing processes will be reviewed and discussed. There are physiological problems of ageing and there are ocular pathologies which can be treated efficiently in time to preserve near and far visual acuity.

The role of social factors in the successful ageing – Systematic review

Purpose Ageing is a complex phenomenon that should be studied in a multidisciplinary approach examining the biological, psychological, and social determinants in it. There is a lack of understanding of how social factors contribute to a better and healthier way of ageing. Based on previous studies social factors have a more essential role in ageing successfully. These factors have a significant influence on mental and physical health as well. The present review aims to collect the most researched social factors related to successful ageing and to examine the associations revealed between social factors and successful ageing. Materials/Methods We conducted a systematic review by the guidelines of the PRISMA statements. We examined the studies included by using a qualitative synthesis to identify the most important social factors and their role in successful ageing. Results In total, 18 original articles published in English between 2015 and 2020 were included in the review. The examined social factors related to successful ageing can be classified into four categories: Social engagement/participation, Social support, Social integration/network, and Socio-demographic/Socioeconomic factors. Social factors are modifiable and protective determinants, they could eliminate the negative effects of psychological factors while modifying the effects of physical determinants of ageing at the same time. Conclusions Our results have implications for future studies, as successful ageing should be examined in a multidimensional way. They should provide further evidence for the mediating/moderating importance of social factors which also have relevance in practice. Social factors could provide a quality life for years to come.

A review of patient safety communication in multicultural and multilingual healthcare settings with special attention to the U.S. and Canada

Purpose The present work aims to raise awareness of the issue of patient safety communication in multicultural and multilingual healthcare settings and to present strategies on how to overcome emerging cultural and language barriers and enable healthcare providers to reduce the risk of miscommunication, prevent inequalities and disparities, and provide their patients with safe and quality care. It also strives to present the policies and measures the United States and Canada have implemented and the strategies U.S. experts have developed to advance effective communication between provider and patient. Methods The literature review was conducted on academic works and publications by health associations, institutes of health, and government departments in topics such as adverse events in health care and strategies to reduce cross-cultural miscommunications and on guides for hospitals. Results/Discussion Cultural diversity in a patient population, language barriers, and a lack of effective communication can impose an increased threat on an individual's health. In order to radically decrease the incidence of adverse events, policies and systems on how to manage multinational and multilingual medical environments should be created at a national level. Cultural competence is also key to delivering care that meets patients' social and cultural needs; furthermore, developing a language access plan and providing language assistance (interpretation, translation) for those in need can greatly contribute to providing quality care. Conclusions Clear communication is key to quality care and patient safety in multicultural and multilingual healthcare environments, but to significantly reduce the incidence of adverse events, policies and systems should be created at a national level.

The application of salutogenesis to teaching and learning – A systematic review

PurposeThe inclusion of salutogenic principles in education deepens and broadens the understanding of the teaching and learning process in a healthy way and opens the potential to create a sound educational environment characterised by the prevention of burnout, improved physical and mental health, and higher levels of achievement. The aim of this review is to fill the lack of comprehensive information regarding the relationship of salutogenesis, sense of coherence, and the process of teaching and learning.Materials/methodsA literature search was carried out in Web of Science and Scopus electronic databases with the cutoff date of July 2020. Search words were sense of coherence, salutogenesis, education, school, academic performance, achievement, students, and their combinations. Altogether 62 articles were found on the relationship of salutogenesis, sense of coherence, and education but only 6 were related to salutogenic teaching/learning process. These were included in the present review.ResultsThe studies included in this review presented salutogenic models related to teaching literacy as a learning process through life, building sustainable relationship between supervisor and students, improving transcultural competence, and being able to solve conflicts across cultures. Practical implications were demonstrated such as the use of drawing as an integration tool to improve self-expression and emotional recognition, realisation of teaching practice as an exercise for self-consciousness, and introducing the concept of teacher as a source of emotional security for students.ConclusionsThe models bring different but equally valuable contribution to the salutogenic teaching process which strengthens the educational environments resulting in better academic performance, as well as physical and mental health.