Geriatric Care最新文献

{"title":"Presbyphagia and dysphagia in old age","authors":"S. Cavallero, L. Dominguez, L. Vernuccio, M. Barbagallo","doi":"10.4081/gc.2020.9137","DOIUrl":"https://doi.org/10.4081/gc.2020.9137","url":null,"abstract":"Although presbyphagia is a clinically relevant problem among elderly population, possibly leading to dysphagia in old age, it remains a still underestimated health condition. The present review analyzes swallowing related anatomical and functional changes during aging, both in healthy people and in those affected by dysphagia. First of all, dysphagia in old people must not be confused with presbyphagia. To distinguish these two different conditions, a correct definition of both should be considered. Subsequently, a comprehensive evaluation including instrumental analysis should be carried out. The aim of this narrative review is to analyze the current knowledge of this clinical condition and to provide the state of art to clinicians. A systematic PubMed research on dysphagia in the elderly was conducted and most relevant and most recent references were manually screened and selected. The aim of a correct diagnosis is to enable the choice of a correct intervention in order to prevent and treat complications of dysphagia, such as ab ingestis pneumonia and malnutrition. Moreover, the assessment, diagnosis and therapy of dysphagia/presbyphagia should include the intervention of different specialists.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.9137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48136353","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: measures to protect older adults from SARS-CoV-2 infection","authors":"I. Ayenigbara, O. Moronkola","doi":"10.4081/gc.2020.9045","DOIUrl":"https://doi.org/10.4081/gc.2020.9045","url":null,"abstract":"As every nation battles the coronavirus disease 2019 (COVID-19) pandemic comprehensively, older adults are by far the most affected group in terms of morbidity and mortality rates. Particularly individuals in the age range of >60 years and with comorbidities and other geriatric conditions are at heightened risk of complications from COVID-19 compared to any other age groups in the world. The time between the infection of severe acute respiratory syndrome-coronavirus 2 (SARSCoV-2) and the manifestation of the symptoms is between two to twelve days. Typical symptoms of COVID-19 are high temperature, dry cough, and breathing difficulties in complicated cases, while new evidence shows atypical presentations of COVID-19 symptoms in older adults, and are highlighted in this review. From this synopsis, we deduced that firstly, the severity of COVID-19 among older adults is because of biological (dwindling immunity with old age), socio-economic (poverty and over-stretched health system) and physical reasons (frailty and comorbidities). Secondly, there is an upsurge in the rates of transmission and COVID-19 fatalities in nursing homes globally. Lastly, to abate the spread of SARS-CoV-2 among older adults, strict adherence to physical distancing, frequent hand hygiene and respiratory hygiene, frequent disinfection of surfaces, stoppage to unnecessary travel and nonessential hospital’s visitations, appropriate use of face masks, healthy life style choices, proper identification and isolation of infected older adults, assistance and support for older adults in the community, and prevention of infections in nursing homes should all essentially be implemented globally. It is recommended that maximum compliance to measures provided in this review should be ensured and implemented. Governments, civil societies and general public should provide supports for older adults during this COVID-19 pandemic period, and new researches should look more into the global severity of COVID-19 on nursing homes and the geriatric populations generally to get progressively feasible exact information that will enable informed preventive choices.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.9045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43158478","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":"QTc prolongation during the SARS-CoV-2 outbreak: clinical risk management through hospital training course, focus on elderly patients","authors":"Nicola Forni, V. Boasi, Katiuscia Sciolè, Silvia Borile, Nicoletta Pingelli, D. Marra, Sara Tita Farinella, G. Cenderello, F. Sànchez","doi":"10.4081/gc.2020.9128","DOIUrl":"https://doi.org/10.4081/gc.2020.9128","url":null,"abstract":"The recent outbreak exposed doctors to a new challenge: treating people without any scientific evidence. All molecules combined in treatment schedules were merged on the basis of weak and anecdotal data so, the recommendations are constantly changing. In this context it is either mandatory for clinicians focusing on the different treatment options and on probable side effects of each molecules. It is well acquired that among elderly within same age group and strain, the outcome will differ according to each patient’s frailty. Moreover, old and frail people are particularly exposed to a double risk: the first one is the age-related mortality and the second one the susceptibility (also age related too) to side effects. Aim of our paper is reporting our experience in reducing toxicity with a constant action of scientific update and subsequent modification in clinical management protocols. Main focus was on frail patients and cardiologic risk-related to hydroxychloroquine.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45658376","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":"Glyphozines and treatment of cardiac disease","authors":"F. Ferrara, G. Granata, C. Pelliccia, R. Porta, A. Vitiello","doi":"10.22541/au.158645606.64403834","DOIUrl":"https://doi.org/10.22541/au.158645606.64403834","url":null,"abstract":"Glyphozines also called SGLT2 inhibitors, are a new class of agents that inhibit reabsorption of glucose in the kidney, in proximal tubules, and therefore lower blood sugar. They act by inhibiting sodiumglucose transport protein 2 (SGLT2). Glyphozines are used in the treatment of type II diabetes mellitus. In studies with canagliflozin, a member of this class, the medication was found to enhance blood sugar control as well as reduce body weight and systolic and diastolic blood pressure. In addition to regulate blood glucose, recent studies have shown that glyphozines have important positive cardiovascular benefits, such as weight loss, decreased volaemia and PA, reduced triglycerides, natriuresis and improved endothelial wall dysfunction. Clinical studies have shown reduction in deaths from cardiovascular events among diabetic patients treated with glyphozines. At the moment these drugs are being studied for an extension of the therapeutic indication also for cardiovascular diseases such as heart failure. In this review, we discuss the class of SGLT2 inhibitors in the treatment of diabetes, and studies focused on their possible role in the treatment of cardiac disease.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44135155","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":"Kinesiophobia dilemma for older adults: a systematic review","authors":"A. Ahangari, Mohammad Abdolrahmani","doi":"10.4081/gc.2020.9056","DOIUrl":"https://doi.org/10.4081/gc.2020.9056","url":null,"abstract":"Kinesiophobia is one of the pain complications which eventually might cause disability. Several studies showed correlation between age-related problems with kinsiophobia. The objective was to investigate clinical trials about managing kinesiophobia among older adults aged +65 years until March 2020. PubMed, CINAHL, Google Scholar, and PsycINFO databases were electronically searched until March 2020. All studies about kinesiophobia, with clinical trials, and randomized trials study design among older adults aged +65 years were included in the review. Two set of searching terms including ‘kinesiophobia AND intervention’ and ‘fear of movement AND intervention’ were used. From a total of 2669 articles, after excluding for different reasons, only three articles with total of 87 participants, mean age 68.5, all from Turkey related to the objectives of this study remained. Two of them were evaluated using two different physiotherapy approaches to manage neck pain and low back pain and one of them was regarding falls. Kinesiophobia was used as measure for the effectiveness of treatments. Older adults with routine and properly designed exercise and activity are healthier, with a lower probability for disability and therefore higher quality of life and longer healthy life. But to reach those goals, agerelated diseases and barriers should be investigated.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.9056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46234620","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":"A case of purple urine bag syndrome in an elderly patient","authors":"R. Cerra, A. Castagna, C. Torchia, Raffaele Costa, Luigi Scalise, Edoardo Suraci, G. Ruotolo","doi":"10.4081/gc.2020.8934","DOIUrl":"https://doi.org/10.4081/gc.2020.8934","url":null,"abstract":"Purple urine bag syndrome is a rare condition that occurs predominantly in the elderly, immobilized and bearer of chronic bladder catheter. It is a phenomenon usually associated with urinary tract infection, particularly in the presence of high bacterial load. The presence of alkaline urine, constipation, high-protein diet and dehydration are predisposing factors. In most cases it is an asymptomatic condition. We described the case of an elderly patient admitted to the geriatric Department in which purple urine was found in the urine collection bag. The culture of urine showed the presence of infection with Klebsiella pneumoniae. Targeted antibiotic treatment and proper hydration determined the resolution of the phenomenon and the resolution of the infection. Although it is an alarming phenomenon due to the particularity of the color of the urine, it is a treatable and solvable condition with an adequate specific antibiotic treatment. Prevention measures are equally effective and consist in eliminating the risk factors for this condition.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.8934","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43858915","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 and cardiovascular disease in elderly patients: a challenge in the challenge","authors":"Raffaele Costa, A. Castagna, C. Torchia, Carmen Ruberto, G. Ruotolo","doi":"10.4081/gc.2020.9121","DOIUrl":"https://doi.org/10.4081/gc.2020.9121","url":null,"abstract":"On 11 March 2020, the World Health Organization declared a pandemic state, in relation to the spread of the severe acute respiratory syndrome-coronavirus disease2, responsible for the coronavirus disease-","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.9121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46073768","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":"Lifestyles and living standard disparities in the pandemicity of COVID-19 in the Global North versus the Global South Countries","authors":"T. T. Desta","doi":"10.4081/gc.2020.9025","DOIUrl":"https://doi.org/10.4081/gc.2020.9025","url":null,"abstract":"The coronavirus disease-19 (COVID19) pandemic is imposing an extraordinary threat to global health. Consequently, fear has been raised in that the COVID-19 pandemic could disproportionately affect lowincome countries. Low-income countries are mainly concentrated in the Global South of the tropics with a high diversity of pathogens, and a considerable proportion of people living under chronic poverty. All these risks might have made Southern people develop a sort of herd immunity and resilience against a broad range of infections. The analysis of the COVID-19 Worldometers data by using country-, territory-, or conveyance-wise summarized in Global North (64 countries) and Global South (147 countries) suggested the high incidence of COVID-19 infection in the North world countries. However, this should be treated with caution given the low testing and contact tracing, and presumably reporting capacity, by the South World countries. Nevertheless, Southern people are living under minimal healthcare, consequently, their relative wellness amidst the COVID-19 crisis could not be overlooked. The observed differences in infectivity, however, might not be ethnically-biased but most likely they could be due to the differences in the living standard, healthcare systems as well as the lifestyle of Global North versus Global South countries. Lifestyles and living standards disparities in the pandemicity of COVID-19 in the Global North versus the Global South Countries There are unfounded thoughts on ethnic-disparity in susceptibility of coronavirus disease-19 (COVID-19). This commentary enlightens the current state and the epidemiology of COVID-19 in the Global North and Global South. A great concern had been raised about the catastrophic impact of COVID-19 in low-income countries.1 Nevertheless, at least, given the current state of the pandem ic, COVID-19 has not been as disastrous in the Global South as it had been anticipated. This has enabled low-income countries to take some advantage in terms of time to learn from Europe and the US about con tainment strategies of the pandemic. Furthermore, it has been repeatedly pointed out that the widespread poverty coupled with communal lifestyle as a powerful obstacle to abide by even very basic preventive guidelines in Southern countries. Another aspect which has been underlined recently as a reason to increased COVID-19-related threat to the South is widespread illiteracy and religious attitudes, for which Southern populations might be uncompliant with protection rules such as wearing masks and social distanc ing. Finally, urban communities of low income countries are considered to live in conditions of high population density, in unhygienic conditions, all factors facilitat ing the spread and pathogenicity related to the COVID-19 pandemic. Fortunately, up-to-date the incidence of COVID-19 in the majority of low-income countries has remained low, although, this could be partly due to low testing and presumably repor","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.9025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43202511","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":"Physical functional profile of hospitalized Brazilian older adults in preoperative vascular surgery","authors":"Juliana Verdini de Carvalho Pinheiro, Mariana Fonseca Vaz, A. Novello, L.C.S. Fonseca, Tiago Batista da Costa Xavier, L. Camilo, M. Orsini, Marco Antônio Alves Azizi, C. S. N. B. Garcia, M. Anna","doi":"10.4081/gc.2020.8784","DOIUrl":"https://doi.org/10.4081/gc.2020.8784","url":null,"abstract":"The objective of the present study was to describe the physical and functioning profile of Brazilian older adults admitted to avascular surgery wards (VSW). This is an observational and cross-sectional study using patients admitted to VSW. The study included subjects considered able to (group 1, G1) or restricted to physical and functional assessment (group 2, G2). Barthel index (BI) was evaluated in G1 and G2 groups, while hand grip strength (HGS), Timed up and Go (TUG), maximal inspiratory and expiratory pressures (MIP and MEP respectively) were assessed only in G1. The data of a total of 104 older adults (G1=56 and G2=48) were analyzed. Most patients had good bed mobility (83.9% in G1 and 75% in G2). There were significant difference between the predicted values and the recorded values obtained for MIP, MEP and HGS (P<0.0001). Pearson correlation showed a significant association between HGS and TUG (P=0.005/r= –0.384) and MEP and TUG (P=0.009/r= –0.353). In conclusion, hospitalized older adults able to perform functional tests showed reduced HGS, MIP and MEP, as well as moderate risk of falls. There was also an association of peripheral muscle strength and expiratory muscle strength with functional mobility evaluated by TUG.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.8784","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45545923","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":"How hospital geriatric care is changing during COVID-19 pandemic: drawbacks and possible solutions","authors":"Liliana Mazza, D. Pinto, P. Calogero","doi":"10.4081/gc.2020.9043","DOIUrl":"https://doi.org/10.4081/gc.2020.9043","url":null,"abstract":"Since the outbreak of coronavirus disease-19 (COVID-19) pandemic, geriatric population has been the most affected due to the peculiarities of the disease in terms of contagiousness and severity. Major changes have been implemented in healthcare structures and facilities worldwide in order to accomplish the necessity to host and isolate infected patients. Simultaneously, many critical issues have emerged concerning medical and nursing assistance to elderly patients, due to the new arrangement of wards and innovative work tools. Acute Geriatric Units dedicated to COVID-19 have been asked to put giant efforts in adapting to new care models in mobility, communication, feeding, basic assistance and caregivers’ involvement. The purpose of this dissertation is to highlight the role of Geriatricians as proactive contributors of new approaches to elderly patients in times of COVID-19, in order to develop a further-thinking working methodology.","PeriodicalId":30930,"journal":{"name":"Geriatric Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/gc.2020.9043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48882717","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}