• Title/Summary/Keyword: geriatric medical center

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Low Intensity Resistance Exercise Training with Blood Flow Restriction: Insight into Cardiovascular Function, and Skeletal Muscle Hypertrophy in Humans

  • Park, Song-Young;Kwak, Yi Sub;Harveson, Andrew;Weavil, Joshua C.;Seo, Kook E.
    • The Korean Journal of Physiology and Pharmacology
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    • 제19권3호
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    • pp.191-196
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    • 2015
  • Attenuated functional exercise capacity in elderly and diseased populations is a common problem, and stems primarily from physical inactivity. Decreased function and exercise capacity can be restored by maintaining muscular strength and mass, which are key factors in an independent and healthy life. Resistance exercise has been used to prevent muscle loss and improve muscular strength and mass. However, the intensities necessary for traditional resistance training to increase muscular strength and mass may be contraindicated for some at risk populations, such as diseased populations and the elderly. Therefore, an alternative exercise modality is required. Recently, blood flow restriction (BFR) with low intensity resistance exercise (LIRE) has been used for such special populations to improve their function and exercise capacity. Although BFR+LIRE has been intensively studied for a decade, a comprehensive review detailing the effects of BFR+LIRE on both skeletal muscle and vascular function is not available. Therefore, the purpose of this review is to discuss previous studies documenting the effects of BFR+LIRE on hormonal and transcriptional factors in muscle hypertrophy and vascular function, including changes in hemodynamics, and endothelial function.

한방병원에 입원한 노인암 환자의 치료 특성 분석 (Analysis of Clinical Characteristics and Treatments among Geriatric Cancer Patients Hospitalized in a Traditional Korean Medical Hospital)

  • 오혜경;이지영;류한성;윤성우
    • 대한한방내과학회지
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    • 제37권2호
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    • pp.412-419
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    • 2016
  • Objective: Because the number of geriatric cancer patients is on the rise but information on treatments for this population is limited, this study aimed to analyze clinical characteristics and the factors that influence treatment decisions among elderly cancer patients.Method: Data on elderly cancer patients (≥65 years of age) who were admitted to a traditional Korean medicine hospital from March 2014 to February 2016 were collected. We compared the clinical characteristics and overall survival rates of the chemotherapy group and the non-chemotherapy group.Results: Nineteen patients were included in this study. Nine people received chemotherapy, and ten people did not receive chemotherapy due to concerns about quality of life. Age, activities of daily living (ADL) score, and Eastern Cooperative Oncology Group (ECOG) performance status all showed differences between the two groups, although median survival times did not differ significantly between the two. Compared with chemotherapy alone, traditional Korean medicine combined with chemotherapy prolonged median survival times.Conclusion: Old age and low ECOG performance status and ADL scores appear to be influential factors for the decision to undergo chemotherapy. Further studies are needed to confirm that these factors influence decisions about cancer treatment methods among geriatric cancer patients.

만성적인 신체질환이 있는 노인 환자의 우울증 조기발견을 위한 병원기반 모델 (A General Hospital-Based Model for Early Detection of Depression in the Geriatric Patients with Chronic Medical Diseases)

  • 박선철;이화영;이동우;한상우;박상호;김여주;최재성;정성원;이소영;나경세;권영준
    • 생물정신의학
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    • 제20권2호
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    • pp.31-39
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    • 2013
  • The geriatric patients with chronic physical diseases are frequently associated with the continuous clusters of depression including nonpathological sadness, subsyndromal depression, minor depressive disorder, and major depressive disorder. Because of the complex and reciprocal relationships among depression, elderly, and chronic physical diseases, screening approaches with specific nosological methods should be needed in the realm of early detection of depression. Cognitive decline is frequently manifested in geriatric depression with medical or neurological diseases. Also, somatic symptoms of depression or emotional symptoms of physical diseases can play a role as a hampering factor in the early detection of depression. Furthermore, after-care has been regarded as an essential factor of depression screening in the geriatric patients with chronic physical diseases. We reviewed the most popular examples of integrated medicine for depression in primary care. Thus, we propose a general hospital-based model for early detection of depression which includes favorable response loop between screening and therapeutic intervention. Our model can be a basis for evidence-based detection and after-care for depression in the geriatric patients with chronic medical diseases.

갈란타민(Galantamine) 투여 후 순수 알츠하이머병 치매와 혼합성 치매 환자의 주의력, 일상생활능력 및 신경정신행동 증상에 대한 효과 평가 (Effects of Galantamine Treatment on Attention, Activities of Daily Living, and Neuropsychiatric Symptoms between the Patients with Pure Alzheimer's Disease and Mixed Dementia)

  • 강효신;윤지혜;안인숙;문유진;황태영;이영민;김혜란;김도관
    • 노인정신의학
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    • 제16권1호
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    • pp.24-30
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    • 2012
  • Objectives : The purpose of this study was to compare the efficacy of galantamine treatment, especially attention ability between patients with pure Alzheimer's disease (AD) and Mixed dementia (MD) during a 24-week trial. Methods : A total of 40 patients were recruited for this 24-week study. The effect of galantamine on attention was measured using Seoul Computerized NeuroCognitive Function Test (SCNT) and frontal functions test of Seoul Neuropsychological Screening Battery (SNSB). Patients'activities of daily living using the Seoul-Activities of Daily Living (S-ADL) and the Seoul-Instrumental Activities of Daily Living (S-IADL) ; behavioral symptoms using the Korean version Neuropsychiatric Inventory (K-NPI) were measured at baseline and 24-week. Results : 17 pure AD patients and 23 MD patients were analyzed in this study. Attention as measured by SCNT was not significantly different from baseline after 24 weeks of treatment in both groups. There was no significant difference between two groups in mean change from baseline in the SCNT, S-ADL, S-IADL and K-NPI scores at 24-week. Conclusion : Galantamine showed a therapeutic effect on cognition, activities of daily living, neuropsychiatric symptoms in pure AD and MD. Furthermore, Galantamine may specifically help to maintain attention and it may have positive effects on other cognitive and functional abilities.

Incidence and Risk Factors of Acute Postoperative Delirium in Geriatric Neurosurgical Patients

  • Oh, Yoon-Sik;Kim, Dong-Won;Chun, Hyoung-Joon;Yi, Hyeong-Joong
    • Journal of Korean Neurosurgical Society
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    • 제43권3호
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    • pp.143-148
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    • 2008
  • Objective: Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods: Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results: POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 mini, and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion: Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.

Postoperative Results of Kyphoplasty for Osteoporotic Vertebral Compression Fractures

  • Yoon, Won-Ki;Roh, Sung-Woo;Rhim, Seung-Chul;Lee, Chun-Sung;Kwon, Soon-Chan;Kim, Jeoung-Hee
    • Journal of Korean Neurosurgical Society
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    • 제37권4호
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    • pp.253-257
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    • 2005
  • Objective: We analyze pain relief, deformity correction and complication rate after percutaneous kyphoplasty for osteoporotic vertebral compression fractures. Methods: The authors retrospectively reviewed medical records and radiological findings of 32 patients who underwent percutaneous kyphoplasty for osteoporotic vertebral compression fractures. Results: The patients had significant pain improvement with the procedure. The visual analogue scale score reduced from 8.6 to 3.4 significantly after the procedure. The midline vertebral body height significantly increased postoperatively, but mean kyphotic angle did not. There was no serious complication except one case of epidural cement leakage without neurological impairment. Conclusion: Balloon kyphoplasty safely can reduce severe back pain and returned geriatric patients to higher activity levels. The midline vertebral height is restored significantly. However kyphotic deformity correction is not significant as contrary to what we expected from the present study before it was carried out.

78세 고령에서의 심장이식 (Heart Transplantation in a 78-year-old Patient)

  • 박병준;박표원;최선우;성기익;양지혁
    • Journal of Chest Surgery
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    • 제41권5호
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    • pp.640-642
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    • 2008
  • 고령은 심장이식 후 사망의 위험인자로 상대적 금기로 알려져 왔으나 최근 일부 연구에 의하면 젊은 환자에 비교하여 초기 및 중기 생존률의 통계적 차이가 없다고 보고되고 있다. 평균 수명의 연장과 보전적 투약 치료의 발전으로 심장이식수술이 유일한 치료로서 합당한 고령의 말기 심질환 환자가 증가하는 추세이다. 본 저자들은 78세의 고령의 환자에게 성공적으로 심장이식수술을 시행하였기에 그 사례를 보고하는 바이다.

고령화 사회 구급서비스 활성화에 관한 연구 - 노인 응급환자 초기대응 시스템 개선방안 - (A Study on the Revitalization of the Emergency Medical Services for a Aged Society - Based on Possible Solutions to Improve Early Response System for Geriatric Emergency Patients -)

  • 정지연;황희진
    • 한국화재소방학회논문지
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    • 제22권5호
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    • pp.99-104
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    • 2008
  • 최근 우리나라는 고령화 사회에 빠르게 진입되었다. 농촌지역의 노인 응급환자 초기 대응 시스템 개선을 위해 마을 방송 장비의 활용과 노인을 위한 응급처치 교육방법의 개선으로 보다 많은 민간구조자원을 확보하여 응급상황 발생시 초기대응 능력을 향상시키고자 본 연구를 실시하였다. 현재 우리나라 119의 노인 응급의료서비스 실태를 살펴보고, 고령화 시대 사회적 안전장치의 역할을 충실히 수행할 수 있는 노인 안전을 위한 구급서비스 개선 방안 및 노인안전 센터 개설로 인한 노인안전 인프라 구축 방안을 모색하고자 하는데 본 연구의 목적이 있다.

산업체 수요기반의 노인치위생학 및 실습 교육과정 운영 사례 연구 (A Case study on geriatric dental hygiene and practical education courses based on industry demand)

  • 최용금;윤지혜
    • 대한치위생과학회지
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    • 제6권2호
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    • pp.141-150
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    • 2023
  • 연구의 배경 및 목적: 본 연구에서는 노인구강관리에 대한 산업체 수요기반의 교육과정을 개발하여 운영함으로써 노인치위생학 교육의 효과를 확인해 보고자 진행하였다. 연구방법: 산업체 수요기반 현장중심 실무교육에 따른 전공역량달성도, 노인치위생과정 인식, 수업만족도의 전후차이를 검증하기 위하여 비모수 분석으로 윌콕슨 부호순위 검정(Wilcoxon signed rank test)을 수행하였으며, 각 요인간의 연관성을 확인하기 위해 스피어만 상관분석(Spearman's correlation analysis)을 수행하였다(p<0.05). 결과: 전공역량달성도의 경우 산업체 수요기반 현장중심 실무교육을 수행 후 '노인과의 의사소통 역량'이 유의미하게 향상되었다(p=0.031). 고찰: 노인치위생학 교육과정은 산업체 현장에서 활용가능한 실무중심의 교육과정이 학습자에게 제공되었을 때 노인에 대한 실제적인 이해와 노인구강관리에 대한 현장실무전공역량이 더욱 개발될 수 있을 것으로 판단된다.

내관지압이 슬관절 전치환술 받은 노인 환자의 오심, 구토 및 통증에 미치는 효과 (Effects of the Nei-Guan (P6) Acupressure on Nausea, Vomiting, and Pain in Geriatric Patients after Total Knee Replacement Arthroplasty)

  • 유제복;장희정;나은희;김선영;신동수
    • 동서간호학연구지
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    • 제17권2호
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    • pp.96-102
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    • 2011
  • Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.