• Title/Summary/Keyword: Older patients

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만성 견관절 동통을 가진 50세 이상 환자의 단순 방사선 사진 분석 (Simple Radiographic Analysis of Chronic Shoulder Pain in Patients 50 Years and Older)

  • 류총일;김휘택;은일수
    • Clinics in Shoulder and Elbow
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    • 제7권1호
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    • pp.14-22
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    • 2004
  • Purpose: To evaluate a usefulness of the simple radiograph in the patients with chronic shoulder pain 50 years and older. Material and method: 1152 patients with chronic shoulder pain and 100 asymptomatic individuals were involved in this study. All patients were 50 years and older. We excluded patients who had a history of fracture or dislocation. Radiographic interpretation was performed on a shoulder AP view, an axillary view and a supraspinatus outlet view. For statistical analysis, a chi-square test was performed. A p value of <0.05 was considered statistically significant. Results: Abnormal radiologic findings were identified in 369(32%) out of 1152 patients with a shoulder pain: greater tuberosity sclerosis, acromial sclerosis, subacromial osteophytes are common abnormal radiologic findings. A rotator cuff tear or impingement syndrome was identified on a final diagnosis in 61(85.2%) out of the 76 patients with radiologic abnormalities in both greater tuberosity and acromion (p<0.05). Abnormal radiologic findings were identified in 18% of the asymptomatic individuals. Conclusion: Simple radiographic analysis is an important primary diagnostic tool in patients (50 years and old) with chronic shoulder pain.

Cox의 상호작용이론을 근거로 한 원예활동 프로그램이 경증치매노인의 일상생활수행능력 및 우울에 미치는 효과 (The Effects of a Horticultural Program based on Cox's Interaction Model on Ability for Daily Life and Depression in Older Patients with Mild Dementia)

  • 윤미진;성경미
    • 재활간호학회지
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    • 제20권1호
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    • pp.12-21
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    • 2017
  • Purpose: This study attempts to examine the effects of a horticultural program on activities of daily living (ADL) and depression among older patients with mild dementia. Methods: This study adopted a quasi-experimental design-based nonequivalent control group pretest and posttest design, enrolling 30 older patients with mild dementia. The Korean Form of Geriatric Depression Scale was utilized, while the data was collected from the experimental group for 60 minutes, twice weekly for 6 weeks in 12 sessions. ADL and depression were assessed for both the experimental and the control group. Overall functions were assessed only for the experimental group. Results: The experimental group showed improvement in physical function, cognitive function, as well as psychological, emotional function and social function following each session (p<.001). The horticulture program was effective in both ADL ($Z^2=5.65$, p<.001) and depression (t=-5.24, p<.001). Conclusion: In this study, the horticultural therapy based on the Cox's interaction model had positive effects for older patients with mild dementia. Therefore, horticultural therapy may be commendably applied to older patients with mild dementia as a nursing intervention.

Clinical Manifestations and Outcomes of Older Patients with COVID-19: A Comprehensive Review

  • Jeong Eun Lee;Da Hyun Kang;So-Yun Kim;Duk Ki Kim;Song I Lee
    • Tuberculosis and Respiratory Diseases
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    • 제87권2호
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    • pp.145-154
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    • 2024
  • The consequences of coronavirus disease 2019 (COVID-19) are particularly severe in older adults with a disproportionate number of severe and fatal outcomes. Therefore, this integrative review aimed to provide a comprehensive overview of the clinical characteristics, management approaches, and prognosis of older patients diagnosed with COVID-19. Common clinical presentations in older patients include fever, cough, and dyspnea. Additionally, preexisting comorbidities, especially diabetes and pulmonary and cardiovascular diseases, were frequently observed and associated with adverse outcomes. Management strategies varied, however, early diagnosis, vigilant monitoring, and multidisciplinary care were identified as key factors for enhancing patient outcomes. Nonetheless, the prognosis remains guarded for older patients, with increased rates of hospitalization, mechanical ventilation, and mortality. However, timely therapeutic interventions, especially antiviral and supportive treatments, have demonstrated some efficacy in mitigating the severe consequences in this age group. In conclusion, while older adults remain highly susceptible to severe outcomes from COVID-19, early intervention, rigorous monitoring, and comprehensive care can play a pivotal role in improving their clinical outcomes.

70세 이상의 고령에서 발생한 기관지 결핵의 임상적 특징 (Clinical Characteristics of Endobronchial Tuberculosis that Develops in Patients over 70 Years of Age)

  • 김휘종;김현식;마정은;이승준;함현석;조유지;정이영;전경녀;김호철;이종덕;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제63권5호
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    • pp.412-416
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    • 2007
  • 연구배경: 폐결핵의 발생은 연령이 증가함에 따라 그 빈도가 증가하는 것으로 알려져 있어 기관지 결핵의 발생률도 고령에서 증가할 것으로 생각된다. 본 연구는 70세 이상의 고령에서 발생한 기관지 결핵의 임상적 특징을 알아보고자 하였다. 방 법: 2003년 3월부터 2006년 6월까지 경상대학교병원에서 기관지 결핵으로 진단 받은 74명의 환자(남:여=12:62, 평균나이: $64.6{\pm}16.2$세)를 대상으로 70세 이상 환자군과 70세 미만 환자군으로 나누어 임상적 특징을 후향적으로 조사하였다. 결 과: 1) 70세 이상의 환자는 41명(55%), 70세 미만의 환자는 33명(45%)이었다. 2) 양군 모두에서 가장 흔한 증상은 기침이었으며, 호흡곤란의 빈도는 70세 이상 환자군이 70세 미만 환자군보다 높았다(31.7% vs. 12.1%). 3) 기관지내시경 소견상 70세 이상의 환자군이 70세 미만의 환자군보다 건락성 괴사형의 비율은 낮았고(39% vs. 66.7%), 부종 충혈형은 상대적으로 높았다(53.7% vs. 27.2%)(p<0.05). 4) 병변의 위치는 기관 또는 주 기관지를 침범하는 경우가 70세 이상의 환자군이 70세 미만의 환자군보다 유의하게 많았다(9.7% vs. 30.3%). 5) 객담 및 기관지 세척액의 항산균 도말 양성률과 배양 양성률은 유의한 차이가 없었다. 결 론: 70세 이상의 고령에서도 기관지 결핵은 흔히 관찰할 수 있으며, 70세 미만의 기관지 결핵 환자와는 다른 몇 가지 임상양상을 보였다.

35세 이상의 심방중격결손의 치료 (Mangement of Atrial Septal Defect In Patients Ages 35 Years or Older)

  • 박철현;오상준;김창호
    • Journal of Chest Surgery
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    • 제24권12호
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    • pp.1161-1167
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    • 1991
  • The study consisted of all patients undergoing surgical repair of isolated secundum type atrial septal defect in patients ages 35 years or older for the period from October 1986 to October 1991. ASD was closed with direct suture in all patients. Response to surgery was excellent. Two patients who had atrial fibrillation was taken low-dose warfarin therapy to prevent stroke. All patients survived operation, and improved by at least one New York Heart Association functional classification. An old age was not a contraindication to surgery.

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노인 혈액투석 환자를 위한 근력강화 운동 프로그램의 효과 (Effects of a Muscle Strength Reinforcement Exercise Program for Older Adult Patients on Hemodialysis)

  • 이제나
    • 노인간호학회지
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    • 제20권3호
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    • pp.204-216
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    • 2018
  • Purpose: The purpose of this study was to examine effects of a muscle strength reinforcement exercise program (MSREP) for older adult patients with hemodialysis (OAPHD) which was designed to improve health status and quality of life of these older adult patients. Methods: Participants were 40 patients with OAPHD: 20 in the experimental group and 20 in the control group. MSREP was conducted with the experimental group for 12 weeks at H geriatric hospital. An assessment was done to determine effects on physical performance, inflammation index, fatigue, muscle strength and quality of life. Short physical performance battery, C-Reactive Protein (CRP), visual analog scale for fatigue, object lifting' proposed by the Life Options Rehabilitation Advisory Council, sit-to-stand test, and quality of life index were used to gather data. Results: Between the 2 groups there was no significant difference in scores for physical performance, fatigue or quality of life. However, the 2 groups showed significant difference in CRP values and muscle power scores on post-test. Conclusion: Findings provide evidence for the potential utility of education for older adult patients with hemodialysis. Also, this program could allow these patients to increase muscle strength, and contribute to achieving better health conditions in OAPHD care.

약년자 폐암 환자의 임상적 특성 (Clinical Characteristics of Young Patients with Lung Cancer)

  • 곽진영;김귀완;류백렬;최성준;김영호;김대한;손현배;이재철
    • Tuberculosis and Respiratory Diseases
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    • 제51권6호
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    • pp.550-558
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    • 2001
  • 연구배경 : 약년자 폐암 환자는 일반 폐암 환자들과는 다른 임상적 특성들이 보고되고 있으며, 생존율에 있어서도 차이가 있다는 보고가 있어왔다. 이에 저자들은 약년자 폐암 환자의 임상적 특성과 생존율 및 생존율에 미치는 인자들을 확인하고자 하였다. 방 법 : 1992년 1월부터 1998년 12월까지 원자력병원에서 원발성 폐암으로 진단된 환자 중 40세 이하의 약년자 폐암 환자 120명을 대상으로 환자의 특성 및 생존율을 분석하였다. 대조군은 같은 기간동안 폐암으로 진단된 41세 이상의 환자 중 120명을 무작위 추출하여 비교하였다. 결 과 : 약년자군에서 여성의 비율이 상대적으로 높고, 조직학적 분류상 선암이 가장 흔한 형태였으며, 비소세포암의 경우 진행된 병기(IIIB와 IV)로 진단된 경우가 많았고, 대조군에 비하여 유의하게 낮은 생존율을 보였다. 생존율에 영향을 미치는 인자로는 진행된 병기만이 유의한 독립변수로 나타났다. 결 론 : 약년자 폐암 환자들은 장노년층의 환자에 비해 진단시 진행된 병기가 많고 낮은 생존율을 보여 더 공격적이라는 것을 알 수 있었다.

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Association of advanced chronic kidney disease with diabetic retinopathy severity in older patients with diabetes: a retrospective cross-sectional study

  • Geun Woo Lee;Chul Ho Lee;Seong Gyu Kim
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.146-155
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    • 2023
  • Background: Despite the recent increasing trend in the prevalence of type 2 diabetes among older individuals, the relationship between diabetic retinopathy (DR) and chronic kidney disease (CKD) in these patients remains unclear. This study investigated the severity of renal dysfunction according to the degree of DR in older patients with type 2 diabetes. Methods: A total of 116 patients with diabetes and CKD stage ≥3 who visited both the nephrology and ophthalmology outpatient departments between July 2021 and January 2022 were screened. There were 53 patients in the no DR group, 20 in the nonproliferative DR (NPDR) group, and 43 in the proliferative DR (PDR) group. Results: DR severity was related to the deterioration of renal function. The proportion of patients with advanced CKD significantly increased with DR severity (p for trend <0.001). In the multivariate regression model adjusted for age of ≥80 years, male sex, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration of ≥10 years, cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared with the no DR group was approximately 4.6 for the NPDR group and approximately 11.8 for the PDR group, which were both statistically significant (p=0.025 and p<0.001, respectively). Conclusion: DR severity in older patients with diabetes may be associated with deterioration of renal function and high prevalence of advanced CKD. Therefore, periodic examination for DR in older patients with diabetes is important for predicting renal function deterioration and CKD progression.

Advantages of Function-Preserving Gastrectomy for Older Patients With Upper-Third Early Gastric Cancer: Maintenance of Nutritional Status and Favorable Survival

  • Masayoshi Terayama;Manabu Ohashi;Satoshi Ida;Masaru Hayami;Rie Makuuchi;Koshi Kumagai;Takeshi Sano;Souya Nunobe
    • Journal of Gastric Cancer
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    • 제23권2호
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    • pp.303-314
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    • 2023
  • Purpose: The incidence of early gastric cancer is increasing in older patients alongside life expectancy. For early gastric cancer of the upper third of the stomach, laparoscopic function-preserving gastrectomy (LFPG), including laparoscopic proximal gastrectomy (LPG) and laparoscopic subtotal gastrectomy (LSTG), is expected to be an alternative to laparoscopic total gastrectomy (LTG). However, whether LFPG has advantages over LTG in older patients remains unknown. Materials and Methods: We retrospectively analyzed data of consecutive patients aged ≥75 years who underwent LTG, LPG, or LSTG for cT1N0M0 gastric cancer between 2005 and 2019. Surgical and nutritional outcomes, including blood parameters, percentage body weight (%BW) and percentage skeletal muscle index (%SMI) were compared between LTG and LPG or LSTG. Survival outcomes were also compared between LTG and LFPG groups. Results: A total of 111 patients who underwent LTG (n=39), LPG (n=48), and LSTG (n=24) were enrolled in this study. To match the surgical indications, LTG was further categorized into "LTG for LPG" (LTG-P) and "LTG for LSTG" (LTG-S). No significant differences were identified in the incidence of postoperative complications among the procedures. Postoperative nutritional parameters, %BW and %SMI were better after LPG and LSTG than after LTG-P and LTG-S, respectively. The survival outcomes of LFPG were better than those of LTG. Conclusions: LFPG is safe for older patients and has advantages over LTG in terms of postoperative nutritional parameters, body weight, skeletal muscle-sparing, and survival. Therefore, LFPG for upper early gastric cancer should be considered in older patients.

Use of Information Technologies to Explore Correlations between Climatic Factors and Spontaneous Intracerebral Hemorrhage in Different Age Groups

  • Ting, Hsien-Wei;Chan, Chien-Lung;Pan, Ren-Hao;Lai, Robert K.;Chien, Ting-Ying
    • Journal of Computing Science and Engineering
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    • 제11권4호
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    • pp.142-151
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    • 2017
  • Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that sICH occurrence is related to weather conditions; therefore, this study used the decision tree method to explore the impact of climatic risk factors on sICH at different ages. The Taiwan National Health Insurance Research Database (NHIRD) and other open-access data were used in this study. The inclusion criterion was a first-attack sICH. The decision tree algorithm and random forest were implemented in R programming language. We defined a high risk of sICH as more than the average number of cases daily, and the younger, middle-aged and older groups were calculated as having 0.77, 2.26 and 2.60 cases per day, respectively. In total, 22,684 sICH cases were included in this study; 3,102 patients were younger (<44 years, younger group), 9,089 were middle-aged (45-64 years, middle group), and 10,457 were older (>65 years, older group). The risk of sICH in the younger group was not correlated with temperature, wind speed or humidity. The middle group had two decision nodes: a higher risk if the maximum temperature was >$19^{\circ}C$ (probability = 63.7%), and if the maximum temperature was <$19^{\circ}C$ in addition to a wind speed <2.788 (m/s) (probability = 60.9%). The older group had a higher risk if the average temperature was >$23.933^{\circ}C$ (probability = 60.7%). This study demonstrated that the sICH incidence in the younger patients was not significantly correlated with weather factors; that in the middle-aged sICH patients was highly-correlated with the apparent temperature; and that in the older sICH patients was highly-correlated with the mean ambient temperature. "Warm" cold ambient temperatures resulted in a higher risk of sICH, especially in the older patients.