• Title/Summary/Keyword: Older Patients

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Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

  • Kwon, Jieun;Kim, Yeun Ho;Yeom, Tae Sung;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • v.18 no.1
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    • pp.36-42
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    • 2015
  • Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.

Clinicopathologic Characteristics and Causes of Postmenopausal Bleeding in Older Patients

  • Jo, Hyen Chul;Baek, Jong Chul;Park, Ji Eun;Park, Ji Kwon;Cho, In Ae;Choi, Won Jun;Sung, Joo Hyun
    • Annals of Geriatric Medicine and Research
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    • v.22 no.4
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    • pp.189-193
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    • 2018
  • Background: This study aimed to reveal the clinicopathologic features and causes of bleeding in older patients with postmenopausal bleeding (PMB) and to investigate the correlation between the ultrasonographic findings and etiology of PMB. Methods: We retrospectively analyzed the causes and clinical characteristics of PMB in 498 patients who were diagnosed between January 2007 and December 2017. The population with PMB was divided into 2 groups according to age: Group A (n=204) included individuals more than 65 years of age and group B (n=294) included those less than 65 years of age. Clinical characteristics such as age, parity, underlying conditions, previous surgical history, and previous menopausal hormone therapy were compared between the groups. Cervical cytology testing and transvaginal ultrasonography were performed in all patients with PMB. Endometrial biopsy was performed in all cases of endometrial thickness ${\geq}5mm$. Results: We examined 498 patients with PMB. In group A, atrophic endometrium (n=125, 61.27%) was the most common cause of PMB. Twenty-three patients had gynecological malignancy (cervical cancer: n=12, 5.88%; endometrial cancer: n=8, 3.42%; ovarian cancer: n=3, 1.46%), and 30 patients had benign gynecological disease (endometrial polyp: n=10, 4.90%; submucosal myoma: n=6, 2.94%; uterine prolapse: n=7, 3.42%; cervical dysplasia; n=5, 2.45%; cervical polyp: n=2, 0.98%). Forty patients had endometrial thickness ${\geq}5mm$. Eight patients were diagnosed with endometrial cancer. All cases of endometrial cancer were diagnosed with endometrial thickness >10 mm. Conclusion: Atrophic endometrium was the most common cause of PMB in both groups, and approximately 12% of cases were associated with gynecological malignancy in older patients.

A Studies on Nutririon of Aged patients in hospital (노인 입원환자들의 영양섭취 실태에 관한 조사연구)

  • 조옥희;이규봉
    • Culinary science and hospitality research
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    • v.6 no.3
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    • pp.263-280
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    • 2000
  • This survey was conducted to investigated the status of nutritional consumption and relationship of nutrition of patients in hospitals from 1998.9.1 to 1998.9.10. Calorie intake of male patients was lower than RDA but that of female patients were higher than RDA except female younger than 64 years old. Protein intake of male patients was 130% higher than RDA, and that of female patients was 150% more than RDA. Calcium intake was lower than RDA in male patients but higher than RDA in female patients except older than 75 years. Iron intake was higher than RDA in all patients except in male patients older than 75 years. while vitamin B$_1$and vitamin C intake was higher than RDA in all patients but vitamin A and niacin intake was lower than RDA. The rich patients intake enough iron through animal foods and stabilized patients intake vitamin B$_2$ more than RDA. All patients were recognized the importance of protein and vegetable for health and they were recognized also careful choosing of foods for health. Positive relationships were showed between intake of nutritional tablet and nutritional status, between less vegetable intake and less intake of calorie, fat, sugar and fiber and between appetite and vitamin B$_1$ and vitamin C. The result showed that the shorter period staying in hospital, the more intake of sugar, vitamin A and vitamin C.

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5 Repetition Sit-to-Stand Test of Stroke patients and Healthy Older (뇌졸중 환자와 노인의 의자에서 일어서기 수행평가)

  • Kwon, Mi-Ji
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.1
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    • pp.101-106
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    • 2014
  • PURPOSE: This study was to provide reference data and examine stroke and healty older differences in sit-to-stand test. This study were to determine utility of the 5 repetition sit to stand for discriminating between fallers and non-fallers, identifying an appropriate cutoff score to delineate between the groups. METHODS: Ninety-five participants were recruited. Seventy-two individuals with stroke and twenty-three healthy older agreed to participate in the study. Falls were recorded using a self-administered questionnaire. The 5 repetition sit to stand test measured the time taken to complete t repetitions of the sit to stand maneuver. The time from the initial seated position to the final seated position after completing five stands was the test measure. A cutoff score regarding 5 repetition sit to stand performance in fallers vs. non-fallers, stroke patients vs. healthy older and <60 vs. $$\geq_-$$ age groups was determined using and ROC curve. RESULTS: Cutoff score of 9.9 seconds were found to be discriminatory between healthy older and subjects with stroke. Cutoff score of 15.5 seconds were found to be discriminatory between fallers and non-fallers. Cutoff score of 18.3 seconds were found to be discriminatory between <60 and $$\geq_-$$ age groups. CONCLUSION: The 5-repetition sit-to stand test is quick, easily administered measure useful for gross determination of fall risk in people with stroke.

A qualitative study on the present working conditions of dental hygienists and the oral health awareness of older adults with dementia - Focus group interviews - (치과위생사의 치매노인 구강건강관리 실태 및 인식에 관한 질적 연구 - 포커스 그룹 인터뷰 적용 -)

  • Jung, Eun-Seo;Choi, Yoon-Young;Lee, Kyeong-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.1
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    • pp.27-40
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    • 2021
  • Objectives: This study investigated the working conditions of dental hygienists and their challenges in providing oral care to older adults with dementia using focus group interviews. Methods: We collected data for approximately a month beginning from August 2020 and divided the study subjects into two groups: the health dental hygienist and the clinical dental hygienist groups. A total of 11 subjects participated in this study. Results: The oral health management of older adult patients with dementia has not been efficiently carried out in local communities or dental medical institutions. In addition, dental hygienists encounter difficulties in managing the oral health of these patients and hope to actively learn more about their special cases. Conclusions: Based on the results of this study, it is necessary to develop a manual or program for the professional implementation of oral health interventions for older adults with dementia.

Thromboembolic Events after Coil Embolization of Cerebral Aneurysms : Prospective Study with Diffusion-Weighted Magnetic Resonance Imaging Follow-up

  • Chung, Seok-Won;Baik, Seung-Kug;Kim, Yong-Sun;Park, Jae-Chan
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.275-280
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    • 2008
  • Objective : In order to assess the incidence of thromboembolic events and their clinical presentations, the present study prospectively examined routine brain magnetic resonance images (MRI) taken within 48 hours after a coil embolization of cerebral aneurysms. Methods : From January 2006 to January 2008, 163 cases of coil embolization of cerebral aneurysm were performed along with routine brain MRI, including diffusion-weighted magnetic resonance (DW-MR) imaging, within 48 hours after the embolization of the aneurysm to detect the silent thromboembolic events regardless of any neurological changes. If any neurological changes were observed, an immediate brain MRI follow-up was performed. High-signal-intensity lesions in the DW-MR images were considered as acute thromboembolic events and the number and locations of the lesions were also recorded. Results : Among the 163 coil embolization cases, 98(60.1%) showed high-signal intensities in the DW-MR imaging follow-up, 66 cases (67.0%) involved the eloquent area and only 6cases (6.0%) showed focal neurological symptoms correlated to the DW-MR findings. The incidence of DW-MR lesions was higher in older patients (${\geq}60$ yrs) when compared to younger patients (<60 yrs) (p=0.002, odd's ratio=1.043). The older patients also showed a higher incidence of abnormal DW-MR signals in aneurysm-unrelated lesions (p=0.0003, odd's ratio=5.078). Conclusion : The incidence of symptomatic thromboembolic attacks after coil embolization of the cerebral aneurysm was found to be lower than that reported in previous studies. While DW-MR imaging revealed a higher number of thromboembolic events, most of these were clinically silent and transient and showed favorable clinical outcomes. However, the incidence of DW-MR abnormalities was higher in older patients, along with unpredictable thromboembolic events on DW-MR images. Thus, in order to provide adequate and timely treatment and to minimize neurological sequelae, a routine DW-MR follow-up after coil embolization of cerebral aneurysms might be helpful, especially in older patients.

Impact of PSA and DRE on Histologic Findings at Prostate Biopsy in Turkish Men Over 75 Years of Age

  • Verim, Levent;Yildirim, Asif;Basok, Erem Kaan;Peltekoglu, Erol;Pelit, Eyup Sabri;Zemheri, Ebru;Tokuc, Resit
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6085-6088
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    • 2013
  • Prostate specidic antigen (PSA) and digital rectal examination (DRE) are the known predictive factors for positive prostate biopsies differing according to the age, region and race. There have been only very limited studies about the impact of PSA on histological findings at prostate biopsy in Turkey. The aim of this study was to evaluate the impact of PSA and clinical stage on histologic findings of prostate biopsy in men older than 75 years of age as a first study in the Turkish population. A total of 1,645 consecutive prostate biopsies were included, with 194 men aged 75 or older. Cancer was identified in 104 patients (53.6%). Of the 104 positive biopsies, Gleason scores were less than 7 in 53 (49%) patients, 7 or greater in 51 (51%) patients. Positive prostate biopsies were significantly correlated with advanced age (p=0.0001), abnormal DRE (p=0.0001) and raised PSA (p=0.0001). The prostate volume was significantly correlated with advanced age especially in prostate cancer patients over 75 years, compared with those under 75 (p=0.0001). These results are useful for counseling men older than 75 years for prostate cancer detection. However, PCa screening decisions are currently based on urologist judgment and detection of latent asymptomatic disease is an important concern regarding costs, overdiagnosis, overtreatment and quality of life (QOL) for men aged 75 years and older. Healthy old patients with a long life expectancy need to be carefully evaluated for eligibility for PCa screening.

Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease (폐쇄성 폐질환 노인 환자와 성인 환자의 흡입제 사용 숙련도와 투약이행도)

  • Kim, Soo Jin;Shin, Yong Soon
    • Korean Journal of Adult Nursing
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    • v.27 no.6
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    • pp.665-672
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    • 2015
  • Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

Comparison of Outcomes after Curative Resection of Primary Lung Cancer between 50 Year or Younger and 70 Year or Older Patients (50세 이하와 70세 이상 원발성 폐암 환자에서의 근치적 수술 후 성적 비교)

  • Lee, Jae-Ik;Kim, Keun-Woo;Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.206-213
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    • 2009
  • Background: Previous series have suggested that younger patients with primary lung cancer exhibit a more aggressive disease course with a worse prognosis, as compared to older patients, although this issue is still debatable. Material and Method: We reviewed the medical records of 79 patients (32 patients 50 years and younger (Group I) and 47 patients 70 years and older (Group II)) who underwent curative resection for primary lung cancer between July 2000 and June 2008. Result: The median age of the patients was 46.5 years in Group I and this was 73 years in Group II. The older patients were more likely to have major comorbidities (44% versus 77%, respectively; p=0.003). Histological examinations identified that the minor histological types (excluding non-small cell lung cancer (NSCLC)) were predominantly found in the Group I patients (16% versus 2%, respectively; p=0.037). For the TNM staging of the NSCLC, with excluding the minor histologic types, a higher proportion of patients had stage III disease in Group I (33% versus 13%, respectively; p=0.038). There was no significant difference in major morbidity (16% versus 30%, respectively; p=0.148) and operative mortality (0% versus 4.3%; p=0.512) between the groups. The mean follow-up interval was 33 months (range: $1{\sim}98$ months) for patients in both groups. For the patients with NSCLC, the five-year overall survival rate was 52.3% for Group I and 53.7% for Group II (p=0.955). The rate of freedom from recurrence at five years was significantly lower for the Group I patients than for the Group II patients (39.4% versus 70.4%, respectively; p=0.027), and only being a member of Group I impacted recurrence, based on the Cox proportional hazard analysis (p=0.034). Of the patients who had recurrence, four patients in Group I underwent aggressive surgical treatment. All of these patients exhibited long-term survival (range: $46{\sim}87$ months). Conclusion: In our study, the early outcome and long-term survival were similar for the younger and older patients after curative resection of primary lung cancer. However, we think that younger patients require meticulous follow-up as they had a tendency to proceed to surgery with advanced stage disease, a higher recurrence rate than did the older patients and the survival rates were improved, even for the recurred cases, with early aggressive treatment.

First-Line Mono-Chemotherapy in Frail Elderly Patients with Metastatic Colorectal Cancer

  • Varol, Umut;Dirican, Ahmet;Yildiz, Ibrahim;Oktay, Esin;Degirmenci, Mustafa;Alacacioglu, Ahmet;Barutca, Sabri;Karabulut, Bulent;Uslu, Ruchan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3157-3161
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    • 2014
  • Background: Unlike for fit elderly metastatic colorectal cancer (mCRC) patients, general approaches to initial treatment for the frail older mCRC patients are not clear. Our aim was to evaluate the efficiency and safety of first-line single-agent treatment in one such group. Materials and Methods: We retrospectively evaluated mCRC patients aged 70 or older with an Eastern Cooperative Oncology Group performance score of 2. They had no prior treatment and underwent first-line single-agent capecitabine or other monotherapies until disease progression or unacceptable toxicity. Results: Thirty-six patients were included. Most (n:28, 77.8%) were treated with capecitabine. One patient achieved a complete response and 5 patients had a partial response for an overall response rate of 16.6%. Twelve patients (33.3%) remained stable. Median progression free survival was 5 months (confidence interval (CI), %; 3.59-6.40) and median overall survival was 10 months (95 CI%; 8.1-11.8). Grade 3-4 toxicity was found in 6 patients (16.6%). Febrile neutropenia was not observed and there were no toxicity-associated deaths. Conclusions: Capecitabine is a safe chemotherapeutic agent with moderate activity for first-line treatment of older metastatic colorectal cancer patients with limited performance status.