Geriatric Care最新文献

{"title":"Elderly with refractory chronic severe hyponatremia and anesthesia management dilemma: a case report with literature review","authors":"Manish Keshwani, H. Karim, Suresh Nagalikar, Deepak Kumar Biswal, Samarjit Dey","doi":"10.4081/gc.2021.9911","DOIUrl":"https://doi.org/10.4081/gc.2021.9911","url":null,"abstract":"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.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42571400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macroglossia reveals multiple myeloma","authors":"M. Bonvicini, D. Crapanzano, S. Fenu, M. Giordano, L. Palleschi","doi":"10.4081/gc.2021.10007","DOIUrl":"https://doi.org/10.4081/gc.2021.10007","url":null,"abstract":"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.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46748971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of the appropriateness of prescribing and frailty in elderly patients using STOPP criteria and Frailty Index in tertiary care teaching hospital","authors":"S. Nariya, A. Pillai, Sneha Agravat","doi":"10.4081/gc.2021.9845","DOIUrl":"https://doi.org/10.4081/gc.2021.9845","url":null,"abstract":"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.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42131818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interdisciplinary intervention is associated with overall improvement of older inpatients in a non-geriatric setting: A retrospective analysis of an observational, longitudinal study with one-year follow up","authors":"F. Müller, A. Meyer, L. Pickert, A. Heeß, I. Becker, T. Benzing, M. Polidori","doi":"10.4081/GC.2021.9723","DOIUrl":"https://doi.org/10.4081/GC.2021.9723","url":null,"abstract":"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.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Yoga possible for elderly care?","authors":"Siu Kan Law, Albert Wingnang Leung, Chuanshan Xu","doi":"10.4081/GC.2021.9815","DOIUrl":"https://doi.org/10.4081/GC.2021.9815","url":null,"abstract":"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.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46800207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract Book of the 35º Congresso Nazionale SIGOT - Live streaming, 16-18 giugno 2021","authors":"Alberto Pilotto","doi":"10.4081/GC.2021.9915","DOIUrl":"https://doi.org/10.4081/GC.2021.9915","url":null,"abstract":"Abstract Book of the 35º Congresso Nazionale SIGOT - Live streaming, 16-18 giugno 2021.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49065202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different diagnostic strategies for different settings","authors":"F. Petrazzuoli","doi":"10.4081/GC.2021.9538","DOIUrl":"https://doi.org/10.4081/GC.2021.9538","url":null,"abstract":"Diagnostic strategies should always take into consideration the setting in which they are administered. The predictive value, positive or negative of a clinical sign or diagnostic test has a different weight in family medicine than in the hospital setting. Many tests have not been formally evaluated in primary care; unfortunately, very often low prevalence settings are used to conduct screening in these populations, and often result in unrealistically high prevalence estimates for chronic disease and these results are then used to conclude that General Practitioners are not good at detecting diseases. In primary care, the prevalence and incidence of disease differs from what appears in the hospital setting, and severe disease occurs less frequently in general practice than in hospital because there is no preventive selection. This requires a specific probability-based decision-making process, based by the knowledge of patients and the community. In primary care, the diagnostic strategy should begin with complaints and symptoms and address uncertainty and complexity, using step-by-step strategies, including watchful waiting, presumptive symptomatic treatment, and focusing on low-tech strategies. The diagnostic process There are 2 fundamental strategies in the diagnostic process in Medicine. (Unpublished data: Terry Shaneyfelt, https: //ebmteacher.com/open-teaching-resources/ accessed 28/11/2020): i) pattern recognition: e.g. shingles, where the presence of specific signs and symptoms is pathognomonic of the disease; ii) probabilistic: e.g. deep vein thrombosis, where the probability of a disease is influenced by the diagnostic test accuracy.1 The pre-test probability is the probability that a patient is affected by a disease, prior to any further diagnostic studies. In the probabilistic diagnostic paradigm, we start form the pre-test probability and after the test result we have a revised probability (post-test probability). Table 1 shows how can we estimate the pre-test probability. When to use a supplementary diagnostic test? Figure 1 shows the diagnostic process that should guide us in establishing a diagnosis. If further testing is needed, then the next step is to choose a diagnostic test. Because there are often multiple tests that could be ordered for a given disease we need to pick the right one for the situation. How to choose a diagnostic test? Before ordering a test, doctors need to think carefully of the pre-test probability. What do we want to do with a test? Rule in a disease or rule out a disease? In order to do this, doctors need to compare the operating characteristics of a test before selecting one, and above all, to think about what they will do with the results of a test. Comparing the operating characteristics of a test before selecting one Table 2 illustrates the role of testing. Do we need a sensitive or a specific test? It depends on the role of testing (rule in or rule out). When we want to rule in a disease, we need a spec","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46803591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory community-based arts for older people living with dementia in the community: how are they evaluated? A scoping review","authors":"Azam Bazooband, H. Courtney-Pratt, K. Doherty","doi":"10.4081/GC.2021.9470","DOIUrl":"https://doi.org/10.4081/GC.2021.9470","url":null,"abstract":"Although the interests in participative arts for people living with a dementia has increased over the last decade, what is yet to be reviewed is how participatory community-based arts activities for this group of people are evaluated. The overall aim of the following scoping review is to understand the scope of measurement/evaluation methods/approaches used in studies that recruited participants with dementia from the community (not from health/clinical or residential aged care settings or nursing homes) and delivered community-based participatory arts activities/programs (not art therapy programs) to them. The methodological framework by Arksey and O’Malley (2005) for undertaking a scoping review article was applied to this study. Collation, summarizing and reporting the results was carried out considering the research questions. 7 articles met inclusion/exclusion criteria published from 2013 to 2020. The type of arts activities included co-designs and co-creation of various types of arts (n=1), museum visiting and art-making activities (n=4), artistic education-based program (n=1), group","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47045752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of COVID-19 patients treated in University Hospital Split, Croatia - specifics related to patients age","authors":"Marija Cavar, Danijela Budimir Mrsic, Ante Luetić, Lara Perkovic Tabak, M. Petricevic, K. Dolić","doi":"10.4081/GC.2021.9351","DOIUrl":"https://doi.org/10.4081/GC.2021.9351","url":null,"abstract":"Different aspects of the coronavirus disease 2019 (COVID-19) infection have been widely investigated since the onset of a pandemic in December 2019. Several studies investigated differences in disease development and presentation compared to patient characteristics. In this paper we present an overview of the first COVID-19 pandemic wave in Dalmatia, Croatia with specifics related to patients’ age. Demographic, clinical and radiological data from hospitalized COVID-19 positive patients in the Clinical Hospital Split over a three-month period were collected and analyzed. Subgrouping and additional analysis were performed: Octogenarians vs Non-octogenarians, and senior residence vs nonsenior residence. 160 COVID-19 positive patients were enrolled. Of those, 61% were females. Median age was 78. More than a half of all patients were senior residents. No differences in final outcome were observed comparing specific medicament treatment. Among Octogenarians group, there were more asymptomatic cases, and higher mortality rate. Some differences in radiological presentation were also observed. Senior COVID-19 positive patients are more often asymptomatic but with higher mortality rates. More attention should be paid to early detection on COVID-19 infection in the senior population.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44580424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccination concerns among elderly people in Hong Kong","authors":"Siu Kan Law, Albert Wingnang Leung, Chuanshan Xu","doi":"10.4081/GC.2021.9629","DOIUrl":"https://doi.org/10.4081/GC.2021.9629","url":null,"abstract":"Not available","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49020672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}