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Coping style is a cognitive or behavioral strategy taken by individuals in the face of stress. Positive coping style is of great significance for improving the physical and mental outcomes of elderly patients with urinary incontinence. Accurate assessment of coping styles for the elderly patients with urinary incontinence can provide reference for the subsequent development of intervention measures. The existing coping style assessment tools for elderly incontinence at home and abroad include specific scale of incontinence, relevant psychological assessment scale, and universal scale. In a word, the progress in the studies on relevant assessment tools is slow, and it mainly focuses on the assessment of female population. The assessment content is relatively single and lacks of pertinence and systematization. In the future, a comprehensive scale with strong adaptability should be developed based on the characteristics of elderly incontinence patients in China.
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Aged , Female , Humans , Adaptation, Psychological , China , Urinary IncontinenceABSTRACT
Objective@#To evaluate the prognostic significance of comprehensive geriatric assessment (CGA) in Chinese elderly acute myeloid leukemia (AML) patients.@*Methods@#73 AML patients over the age of 60 were enrolled. CGA stratification included the following 3 instrument assessment: activity of daily living (ADL) ; instrumental activity of daily living (IADL) ; comorbidity score according to the Modified cumulative illness rating score for geriatrics (MCIRS-G) . According to CGA and age, the enrolled patients were grouped into 'fit’, 'unfit’ and 'frail’ categories.@*Results@#The median age of 73 elderly AML patients were 75 years old. According to CGA, 37 (50.1%) patients were classified as 'fit’, 14 (19.2%) as 'unfit’, and 22 (30.7%) as 'frail’. 33 (89.2%) patients in fit group received induction chemotherapy, or demethylation treatment, as 8 (57.9%) in unfit, 10 (45.5%) in frail. The overall response rate was 68.7%、62.5%, 75.0% in fit, unfit, and frail group, respectively (χ2=0.615, P=0.769) .The early mortality (8 weeks) in three groups were different: 5.4%, 7.1%, 27.3%, respectively (P<0.05) . The 1-year overall survival in the 'fit’, 'unfit’ and 'frail’ groups was 64.9%, 28.6% and 22.7%, respectively (P<0.05) . The CGA score, age, ECOG score, WHO classification (2016) were the prognostic factors of AML patients.@*Conclusion@#CGA can be used to determine the prognosis of elderly AML patients.
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Objective: To evaluate the prognostic significance of comprehensive geriatric assessment (CGA) in Chinese elderly acute myeloid leukemia (AML) patients. Methods: 73 AML patients over the age of 60 were enrolled. CGA stratification included the following 3 instrument assessment: activity of daily living (ADL) ; instrumental activity of daily living (IADL) ; comorbidity score according to the Modified cumulative illness rating score for geriatrics (MCIRS-G) . According to CGA and age, the enrolled patients were grouped into 'fit', 'unfit' and 'frail' categories. Results: The median age of 73 elderly AML patients were 75 years old. According to CGA, 37 (50.1%) patients were classified as 'fit', 14 (19.2%) as 'unfit', and 22 (30.7%) as 'frail'. 33 (89.2%) patients in fit group received induction chemotherapy, or demethylation treatment, as 8 (57.9%) in unfit, 10 (45.5%) in frail. The overall response rate was 68.7%、62.5%, 75.0% in fit, unfit, and frail group, respectively (χ(2)=0.615, P=0.769) .The early mortality (8 weeks) in three groups were different: 5.4%, 7.1%, 27.3%, respectively (P<0.05) . The 1-year overall survival in the 'fit', 'unfit' and 'frail' groups was 64.9%, 28.6% and 22.7%, respectively (P<0.05) . The CGA score, age, ECOG score, WHO classification (2016) were the prognostic factors of AML patients. Conclusion: CGA can be used to determine the prognosis of elderly AML patients.
Subject(s)
Aged , Humans , Comorbidity , Geriatric Assessment , Leukemia, Myeloid, Acute , PrognosisABSTRACT
To explore the characteristics of exploratory eye movement (EEM) and hypothalamic-pituitary-adrenal axis (HPA) in elderly patients with acute bipolar and unipolar depression. Methods Thirty-eight elderly patients with bipolar depression (bipolar group) and thirty-nine patients with unipolar depression (unipolar group) were enrolled. The 24-item Hamilton depression rating scale (HAMD-24) was used to evaluate depressive symptoms. The levels of peripheral serum adrenocorticotropic hormone (ACTH) and cortisol (COR) were detected. EEM was recorded to obtain the number of eye fixation (NEF), responsive search score (RSS) and discriminant analysis (D). Results Compared with the unipolar group, the bipolar group had earlier onset, longer duration, and more admissions (P＜0.05). In comparison with the bipolar group, the unipolar group had higher levels of ACTH and COR (P＜0.05), and higher abnormal proportion of COR and ACTH levels. D-values were higher and RSS-values were lower in unipolar group than in bipolar group. There were no significant differences in NEF and HAMD total scores and its subfactors between the two groups (P＞0.05). Correlation analysis showed that the D value of unipolar group was positively correlated with COR level (r=0.482, P=0.002) but not with other indexes (P＞0.05). There were no significant correlations between EEM parameters and serum levels of HPA hormones in bipolar group (P＞0.05). Conclusion There are different clinical features, EEM indicators, the serum levels of ACTH and COR between acute unipolar and bipolar depression, which suggests the heterogeneity between the two diseases.
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Objective To compare the effect between enteral nutrition and parenteral nutrition among elderly patients with critical pulmonary infection. Methods A total of 60 elderly patients with critical pulmonary infection from October 2011 to May 2014 were randomly divided into enteral nutrition group and parenteral nutrition group with 30 cases each. After 2 weeks of nutritional support, the nutritional status, liver function, complications, hospitalization costs and time were compared. Results Hemoglobin, albumin, prealbumin, total protein was (136.20 ± 3.53) g/L, (40.25 ± 1.65) g/L, (95.97 ± 4.22) mg/L, (75.30±5.30) g/L in enteral nutrition group and (128.10±4.22) g/L, (36.80±1.17) g/L, (84.08±4.86) mg/L, (63.76±6.92) g/L in parenteral nutrition group, there was significant difference between 2 groups (t=24.36-83.76, all P<0.01). Alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin was (57.47±9.08), (33.53±4.21), (13.82±2.59), (5.66±1.22)μmol/L in enteral nutrition group and (75.77 ± 6.96), (47.93 ± 8.28), (24.70 ± 6.44), (14.77 ± 2.77)μmol/L in parenteral nutrition group, there was significant difference between 2 groups(t=30.90-305.34, all P<0.01 ). The complications of enteral nutrition group in intestinal infection rate was 10.0%(3/30), urinary tract infection was 13.3%(4/30), constipation was 6.7%(2/30), and parenteral nutrition group were 36.7%(11/30), 33.3%(10/30), 63.3%(19/30), the difference between 2 groups was statistically significant (χ2=5.96, 3.35, 21.17, all P<0.05). The hospitalization costs and the hospitalization time was (3345.00±617.80) yuan, (18.00±3.70) d in enteral nutrition group and (7617.00±870.76) yuan, (28.00±5.67) d in parenteral nutrition group, the difference between 2 groups was statistical significance (t=2779.11, 27.31, all P<0.05). Conclusions Early enteral nutrition or transit parenteral nutrition to enteral nutrition should be applied among elderly patients with critical pulmonary infection in order to improve nutritional status, enhance immunity, reduce complication, and promote recovery.
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Objective To compare the effect between enteral nutrition and parenteral nutrition among elderly patients with critical pulmonary infection. Methods A total of 60 elderly patients with critical pulmonary infection from October 2011 to May 2014 were randomly divided into enteral nutrition group and parenteral nutrition group with 30 cases each. After 2 weeks of nutritional support, the nutritional status, liver function, complications, hospitalization costs and time were compared. Results Hemoglobin, albumin, prealbumin, total protein was (136.20 ± 3.53) g/L, (40.25 ± 1.65) g/L, (95.97 ± 4.22) mg/L, (75.30±5.30) g/L in enteral nutrition group and (128.10±4.22) g/L, (36.80±1.17) g/L, (84.08±4.86) mg/L, (63.76±6.92) g/L in parenteral nutrition group, there was significant difference between 2 groups (t=24.36-83.76, all P<0.01). Alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin was (57.47±9.08), (33.53±4.21), (13.82±2.59), (5.66±1.22)μmol/L in enteral nutrition group and (75.77 ± 6.96), (47.93 ± 8.28), (24.70 ± 6.44), (14.77 ± 2.77)μmol/L in parenteral nutrition group, there was significant difference between 2 groups(t=30.90-305.34, all P<0.01 ). The complications of enteral nutrition group in intestinal infection rate was 10.0%(3/30), urinary tract infection was 13.3%(4/30), constipation was 6.7%(2/30), and parenteral nutrition group were 36.7%(11/30), 33.3%(10/30), 63.3%(19/30), the difference between 2 groups was statistically significant (χ2=5.96, 3.35, 21.17, all P<0.05). The hospitalization costs and the hospitalization time was (3345.00±617.80) yuan, (18.00±3.70) d in enteral nutrition group and (7617.00±870.76) yuan, (28.00±5.67) d in parenteral nutrition group, the difference between 2 groups was statistical significance (t=2779.11, 27.31, all P<0.05). Conclusions Early enteral nutrition or transit parenteral nutrition to enteral nutrition should be applied among elderly patients with critical pulmonary infection in order to improve nutritional status, enhance immunity, reduce complication, and promote recovery.
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Objective To observe the efficacy and safety of trimetazidine/coenzyme Q10 combination in the treatment of the elderly patients with chronic heart failure(CHF).Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group.Patients in control group received optimal conventional CHF therapy according to the guideline for CHF,while patients in intervention group received trimetazidine of 20 mg,3 times per day,coenzyme Q10 20 mg,3 times per day,additionally for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),plasma brain natriuretic peptide (BNP),6 min walking distance (6MWT) and NYHA cardiac function classification of two groups before and after treatment were observed.Results Before treatmen,the NYHA function class of patients in intervention and control groups were 2.8±0.7,2.7±0.7 respectively,after treatment were 2.1± 0.6,2.4 ± 0.7 respectively,the differences were significant before and after treatment (t=6.808,2.249;P＜0.01,P＜0.05).Before treatment,BNP of intervention and control groups were (540±351)ng/L,(483 ± 351) ng/L respectively,after treatment were (219± 172) ng/L,(316 ± 202) ng/L respectively,the differences were significant before and after treatment (Z =-4.927,-4.042;P ＜ 0.01).Moreover,after treatment,NYHA function class and plasma BNP in intervention group were significantly better than those in control group (t =-2.109,P ＜ 0.05;Z =-2.219,P ＜ 0.05).Before treatment,LVEF,LVEDD and 6MWT of intervention group were (44.3 ± 3.1) ％,(54.0 ± 4.7) mm and (217.0 ± 60.9) m respectively,after treatment were (46.8±3.9) ％,(53.2±4.3) mm and (267.0±91.1) m respectively,the differences were significant before and after treatment(t=-8.313,2.254,-4.561;P＜0.01 or P＜0.05).Moreover,after treatment,LVEF and 6MWT in intervention group were significantly better than those in control group ((44.9± 3.5)％,(213.2 ±78.1) m;t =2.000,2.186;P ＜ 0.05).No significant adverse events were detected in the intervention group.Conclusion Combination of trimetazidine and coenzyme Q10 on the basis of the conventional treatment in the elderly with CHF,can further improve cardiac dysfunction and have a good safety.
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Objective To explore the effect of transradial approach in percutaneous coronary intervention for elderly patient with coronary artery disease,and provide reference for clinic. Methods There were 198 patients older than 70 years with coronary artery disease in our hospital from March 2007 to March 2013,who were divided into the radial group(n=100) and the femoral group(n=98) according to differ-ent puncture pathways. The X-ray exposure time,operative time,amount of contrast medium,the success rate of puncture,achievement ratio of operation and venous complications were compared and analyzed. Results The X-ray exposure time,operative time,amount of contrast me-dium,the success rate of puncture,achievement ratio of operation of 2 groups has no significant differences(P>0. 05). The venous complica-tion of radial group was less than that of femoral group,the difference was statistical significance(P<0. 05). Conclusion The transradial approach in percutaneous coronary intervention for elderly patient with coronary artery disease was feasible and safe,with less complication.
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Objective To observe the impacts of lumbar plexus block combined with sciatic nerve block on postoperative cognitive function and plasma S100βlevel in eldly patients undergoing hip surgeries.Methods Sixty patients of ASA Ⅱ or Ⅲ aged 65-85 years,undergoing selective hip sur-geries,were randomly divided into 2 groups (n=30 each).Group G received general anesthesia with tracheal intubation,while group L received ultrasound-guided lumbar plexus block and parasacral sci-atic nerve block combined with general anesthesia.The mini-mental state examination (MMSE)score was recorded before anesthesia,1 d,3 d and 7 d after operation.The plasma S100βlevel was detected before anesthesia,1 h and 7 d after operation.Results The MMSE scores declined on 1 d after oper-ation in both groups(P <0.05),and the value was lower in group G(P <0.05).There were 18 (56.7%)patients diagnosed with POCD in group G at the first day postoperatively,while it was 10 (33.3%)in group L,and the difference was significant(P<0.05).The MMSE scores were still low-er at 3 d after operation (P<0.05).The concentrations of plasma S100βincreased in both groups at 1 h after operation,and it was more obviously in group G (P <0.05).Conclusion Lumbar plexus block combined with parasacral sciatic nerve block might reduce the stress reaction and dosages of general anesthetics in eldly patients undergoing hip surgeries,minimize the damages of central nervous system,protect the cognitive function and reduce the incidence of POCD.
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Objective To explore the eorrelafion factors of health promotion lifestyle of the elderly los-ing their land and sea estate. Methods Using the health value scale, health promotion lifestyle profile and the general conditions scale to investigate the health value, health promotion lifestyle and general conditions of 85 old people losing their land and sea estate in Dalian development area. Results There was no correlation between health value and health promotion lifestyle of the eldly, age, education degree, number of children and previous employment were rehted with the health promotion lifestyle. Conclusions There was distance be-tween their thought and actual health behavior of the elderly, community management personnels and med-ical workers should strengthen the concrete intervention in lifestyle, not simply relying on propaganda of the importance of health.
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Objective To explore the effect and methods of hip prosthesic replacement of comminuted interochanteric fracture of femur in the eldly.Methods We adopted bone cement hip prosthesic replacements to treat interochanteric fracture of femur in the the eldly.There were 34 cases,with male 11 cases and female 23 cases,aged 74 ～90years old.The fracture was classified according to Evans,with Ⅰa 4 cases,EvansⅠb 12 cases,EvansⅠc 7 cases,EvansⅠd 8cases and EvansⅡ 3 cases.Results All 34 cases got operation successfuly,with the follow-up time of 7 to 48 months postoperatively for all 34 cases.The average hospital stay of the patients was 21 days.The average time to ambulation was 13 days.The incidence rate of the hip joint was 10 percent.Conclusion Bone cement twin exceedingly prosthesic replacement for interochanteric fracture in the the eldly has advmtages of early full weight-bearing and rapid rehabilitation.
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[Objective]To discuss the factors affecting the healing of trochanteric fracture in the eldly and the way to avoid the medical misplay which may occur.[Method]1.The outcome of 100 trochanteric fracture in the eldly were reviewed in order to analyze the flaw in their treatment and the reasons for non-union.Case history before injuries were inspected and active measures were taken.Some patients with severe condition in cardiovascular or respiratory system were treated by special department.2.Early and concrete surgical intervention were taken.3.Early exercise were discouraged to avoid fracture diseases(eg.Osteoporosis,articular degeneration,muscular flappy).[Result]Totally 100 patients were followed up for 1～5 years(average,3.8 years).Two patients(2%) died and 78(78%) regained normal living activities,12(12%) partially regained normal activities and 6(6%) lost their ability to normal life.Totally 98 patients receiving complete follow up,68 healed within 8～10 months,22 patients' healing time were longer than 10 months(included 3 mal-union with chronic infection).Internal fixation complication occurred in 12 patients(8 looses,4 ruptures).[Conclusion]For trochanteric fracture in the eldly people,early operation in the context of effective control over the systemic disorders could decrease the incidence of post-traumatic complication.Active exercise after operation could effectively improve the fracture healing and patient's life quality.