The correlated research on diabetes distress and social support of elderly patients with diabetes mellitus / 现代临床护理

Objective To investigate the correlation between diabetes distress and social support of elderly patients with diabetes mellitus. Methods Three instruments,including the general information questionnaire,the diabetes distress scale (DDS)and the social support rating scale (SSRS)were used to investigate the correlation between diabetes distress and social support of 95 elderly patients with diabetes mellitus from the endocrinology department of two tertiary level first-class comprehensive hospitals from at Novenber 2017.Results The total scores of diabetes distress are (32.7±11.5),at the level of mild distress.The proportion of moderate/severe level is 31.6%(30/95).The diamensions of "routine life distress" and "emotional distress" are most prominent;Social support overall and all diamension scores are lower than the model (all P<0.05);There is a significantly negative correlation between social support and diabetes distress overall,physical distress,routine life distress and interpersonal distress (all P<0.05). Conclusions The elderly patients with diabetes mellitus have different levels of diabetes distress and low level of social support.There is a negative correlation between diabetes distress and social support.We should strengthen the evaluation of diabetes distress and social support of the elderly patients with diabetes mellitus in clinical work,and take individualized interventions to improve the level of social support,in order to decrease diabetes distress and improve the quality of life.

Efficacy evaluation of laparoscopic Roux-en-Y gastric bypass on patients ≥60 years three years after / 中华内分泌外科杂志

Objective To evaluate the treatment outcome of laparoscopic Roux-en-Y gastric bypass on old patients (≥60 years old) 3 years after surgery.Methods The clinical data of 116 patients who underwent LRYGB from Jan.2011 to Mar.2014 were retrospectively examined.Patients were divided in two group:group≥ 60 years comprised of 46 patients,group ＜60 years comprised of 70 patients.Preoperative and postoperative weight,blood glucose,blood lipid,hypertension and complication were evaluated,and the efficacy on the two groups was compared.Results The average age of group≥60 years was (63.1±2.5)years and the mean duration of diabetes was (11.3±4.8) years.Mean weight decreased from (81.8±12.7)kg to (64.6±11.7)kg (P＜0.01),mean BMI decreased from (30.5±3.8) kg/m2 to (24.0±4.1) kg/m2 (P＜0.01),glycosylated hemoglobin(HbA1c) decreased from (9.0±2.0)％ to (7.06±126)％ (P＜0.01),and the remission of diabetes was 45.7％.Significant difference was also found in weight,BMI,EWL％,FBG,PBG,HbA1c,HOMA-IR,Ch,TG,LDL-C,hypertension at 3 years after surgery (P＜0.05),but HDL-C level was similar after the operation.There was no significant difference between group≥60 years and group ＜60 years(P＞0.05) except HbA1c(P＜0.05).The incidence of postoperative complicationswasnot statistically significant(P＞0.05).Conclusions LRYGB is a safe and effective treatment for old patients with obesity and T2DM.The remission rate of T2DM 3 years after surgery was similar between the 2 groups.

Primary total hip arthroplasty versus hemiarthroplasty for displaced neck femur fractures in older patients

Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. Objectives: To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. Materials and methods: We prospectively as well as retrospectively studied 46 patients treated with total hip replacement or hemiarthroplasty. Pain, range of motion, hip function, haris hip score and complications were assessed clinically while hip stability, femoral anteversion, acetabular cup inclination and acetabular erosions were assessed radiographically. Results: In our study according to Harris hip score, group A (hemiarthroplasty group) showed 58.33% excellent to good result whereas 33.34% shows fair to poor result. In group B (total hip replacement group) 90.91% showed excellent to good result and 9.08% showed fair to poor result. In this study, the overall Harris hip score was 76.33 with SD±19.091 in hemiarthroplasty group and 86.45 with SD±6.363 in Total hip replacement group with p-value 0.0224(<0.05). Nitin Kumar Singh, Himanshu Jain, Sonal Garg, Sachin Yadav. Primary total hip arthroplasty versus hemiarthroplasty for displaced neck femur fractures in older patients. IAIM, 2017; 4(10): 209-215. Page 210 Conclusion: So we concluded in our one year of study that total hip replacement had better functional outcome in fracture neck of femur in elderly treated by either hemiarthroplasty or total hip replacement and total hip replacement is less painful than hemiarthroplasty.

Rapid rehabilitation nursing mode reduces postoperative complications in elderly patients with appendicitis / 现代临床护理

Objective To investigate the effect of rapid rehabilitation nursing mode on postoperative complications in elderly patients with appendicitis. Methods Forty-eight elderly patients with appendicitis underwent surgery from July 2013 to June 2014 were set as the control group, and another fifty-three elderly patients from July 2014 to June 2015 as observation group. The patients in the control group were treated with routine care while the patients in the observation group with rapid rehabilitation nursing. Operative complications, gastrointestinal tumor recovery and postoperative hospitalization time were compared within one week after the operations between two groups. Result The rates of constipation, abdominal distention, chills and dysuria in the observation group were significantly lower than those of the control and the time of anal first exhaust, defecation and postoperative hospitalization in the observation group were significantly lower or shorter than those in the control group (all P<0.05). Conclusion The rapid rehabilitation nursing mode based on evidence can reduce surgery complications in elderly patients, promoter recovery and shorten hospitalization time.

Characteristics of cerebral Infarction in young and old patients / Монголын Анагаах Ухаан

Background Ischemic stroke or cerebral infarction in young adults (20-50 years) is relatively frequent, accounting for more than 10%-26% of all first strokes and its incidence rises steeply with age. Causes of “Young stroke” are heterogeneous and while it generally has a good prognosis, it has a significant socioeconomic impact, including functional deficits and financial costs. The most frequent causes of cerebral infarction in young adults are cardio-embolism, hypertension, premature atherosclerosis, migraine, smoking and hypercoagulable states. Objective The aim of this study was to compare characteristics of cerebral infarction between young (20-49 years) and old (50-89 years) patients undergoing investigations and treatment according to one common protocol in the tertiary hospital. Methods This Descriptive case series study was conducted in Department of Neurology of First State Central Hospital from October 2014 to July 2016. During this study, we observed 220 patients with first-onset of cerebral infarction from which 90 young patients (under 50 years) and 130 old one (above 50 years), based on prospective study. Data regarding the etiology and risk factors of the stroke, clinical manifestations, and diagnostic test results of patients were examined during their hospital treatment as well as a NIHSS, modified Rankin Scale scores, and Barthel Index at admission and discharge, also at 21 day. Stroke subtyping was conducted in accordance with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Results In total, 220 patients with cerebral infarction were included, from which 90 (40.9%) were 20-50 years and 130 (59.1%) were 50-89 years. The proportion of males was higher among both groups: 61.1% vs. 70.0%. Common causes for cerebral infarction in the young patients were current smoking (53.3.1% vs. 37.8%), long-term alcohol consumption (51.1 vs. 12.3), cardiac embolism (36.0% vs. 16.2%), migraine with aura (25.5% vs. 12.2%), infective diseases (15.6% vs. 0.8%), and oral contraceptive use (14.4 vs. 0%). Leading causes for ischemic stroke in old patients were the conventional risk factors such as hypertension (75.4% vs. 38.9%), atherosclerosis (66.9% vs. 31.1), coronary artery disease (24.3% vs. 12%), and diabetes mellitus (26.9% vs. 6.7%). Most of the young stroke patients demonstrated good functional outcomes, at the time of discharge (71.1% vs. 60%) and three weeks (86.6% vs. 66.2%) patients had Rankin Scale scores in the range of 0-2. Conclusions There are significant differences between young and old patients with cerebral infarction regarding to risk factors, etiological subtypes and improvement of functional deficits associated with the stroke. However, severity of stroke on admittance is similar but three weeks outcome is different among young and old patients with relatively rapid improvement of functional deficit in young stroke patients than old one.

Violencia sobre personas de la tercera edad con demencia Policlínico Cristóbal Labra Lisa. 2010 / Violence on old persons with dementia Policlínico Cristóbal Labra Lisa. 2010

Introducción: las demencias son enfermedades degenerativas que afectan a 35.6 millones de personas en el mundo y a más de 100 000 en Cuba; constituyen un acontecimiento vital estresante y hacen al anciano muy dependiente de otros y, por tanto, presa fácil de violencia. Objetivo: caracterizar los pacientes con demencia, según grupos de edades, sexo y nivel educacional, manifestaciones clínicas e identificar las conductas violentas, ejercidas sobre ellos, en la consulta de demencia y de terreno durante marzo a agosto de 2010. Material y Método: se realizó un estudio descriptivo desde el 1ero de marzo al 31 de agosto de 2010, en la consulta de demencia y/o en terreno pertenecientes al Policlínico Cristóbal Labra. La información se obtuvo mediante la aplicación de los siguientes instrumentos: Miniexamen del estado mental del anciano, criterios del DSM-IV, la escala de Zarit, Yasavage y la aplicación de una encuesta creada por la autora. Se utilizaron variables cuantitativas y cualitativas; los datos se recogieron en una planilla previamente diseñada y se procesaron de forma automatizada. Los resultados se mostraron en tablas y/o gráficos, y se calcularon medidas de resumen (frecuencias absolutas y porcentajes). Resultados: la demencia se relacionó con aumento de la edad, sexo femenino y menor grado de escolaridad. Los principales síntomas que generaron violencia fueron la pérdida de memoria e insomnio, predominó la Violencia Psicológica; las hijas fueron las principales maltratadoras. Conclusión: la demencia en adultos mayores constituyó un factor estresante generador de violencia en los cuidadores.

Introduction: the violence against the older persons is not a recent, it has been producing since many time ago, it real number is unknow. The dementia is a neurodegenerative disorders, already 35.6 millones of persons in the world and more of 100 000 en Cuba are afected by this pathology. The dementias are an important cause of violence because it produced a big uncapacity physical and intellectual. Objetives: caractherize pacient with dementia, by age, educacional level and sex, know mainly symptoms that produce violence in their mainly parent, diferents types of violences, principle clinical symptoms of psicologycal violence, persons responsible of injuries. Material and Methods: we made a descriptive estudies, since march 1er to agust 31, 2010 about the behavior of the violence on this kind of pacients and it relation with their parent. We used Minimental de Folstein, DSM-IV, Zarit, Yasavage test. Also we used the National Aging Resource Center of violence and the test made for the author. Results: dementias be increased in old patients, women were more afected, it incressed in patient with low educational level, symptoms more frequently found were: memory loss e insomny. The psychological violence was the principal type of violence found, the daughters had more violence behavior. Conclusion: the dementia on old persons produce a lot stress in persons that take care them.

Effect evaluation of application of disease condition anti medication record card in family beds patients / 中国实用护理杂志

Objective To explore the application effect of disese condition and medication record card in family beds patients. Methods 126 family beds patients were divided into the observation group and the control group with 63 cases in each group. The control group used traditional oral health education and medication instrucfion, while in the observation group,nurses gave the disease condition and medication record cards to every patient and guided the implementation. Using self-designed questionnaire, mastering of self-care knowledge, satisfaction degree with nursing work by doctors and patients' accompaniea and medication compliance of patients were investigated upon admission and 6 months after hospitalization. Results After the observation group used disease condition and medication record cants, their mastering of serf-care knowl-edge, satisfaction degree with nursing work by doctors and patients' accompanies and medication compliance of patients were greatly higher than those of the control group. Conclusions Through the application of disease condition and medication record cards, patients can effectively improve their grasp of self-care knowledge, im-prove satisfaction degree with nursing work by doctors and patients' accompanies and patients' medication com-pliance.

Analysis on Risk Factors of Fall in Older Psychiatric Inpatient and Preventing Measures / 中国康复理论与实践

@#Objective To estimate the risk factors of fall happening in the old inpatient of the department of psychiatry and make up preventing measures.Methods 128 old inpatient(36 male cases and 92 female cases,whose age were older than 60) were surveyed.All of the patients were evaluated for risk factors and were interfered by safe nursing and follow-up in duration of hospital stay and in one year post-discharge in order to prevent the occurrence of accident fall.Results Of the 128 investigation patients there were 49 patients(38.3%) who had fall history in the past year.And the female falling patients were 39,while the male falling patients were 10.There were no significant statistical difference between the male and female cases(P>0.05).Of the 128 investigation patients there were 2 fall patients(1.6%) after 1 year safe nursing interference(P<0.001).The risk factors found by Logistic analysis were non-cooperation,poor action ability,blurred vision and taking antipsychotic drug.Conclusion The risk ratio of old inpatient of the psychiatric department is high.The accident of fall should be prevented efficiently.

Prevalencia de las prácticas religiosas, disfunción familiar, soporte social y síntomas depresivos en adultos mayores: Cali, Colombia 2001 / Prevalence of religiosity, family function, social support and deppresive symptoms in old people: Cali, Colombia, 2001

Objetivo: Determinar la prevalencia de las prácticas religiosas, el soporte social y la disfunción familiar en adultos mayores con síntomas depresivos. Materiales y métodos: Se realizó un estudio descriptivo en el Centro de Atención Ambulatoria La Selva del Instituto de los Seguros Sociales de Cali, Colombia en el 2001. Se aplicaron la escala de religiosidad intrínseca/extrínseca (Gorsuch-McPherson), la prueba de APGAR Familiar y la escala de depresión geriátrica (EDG-Yesavage), se evaluaron la frecuencia de la oración personal, grupal o comunitaria y la lectura de los Libros Sagrados de acuerdo con su religión. Resultados: Se estudiaron 136 adultos mayores, con una edad promedio de 69.2±6.4 años, 78 (57%) hombres, 82 (60%) eran casados y 21 (15%) viudos. De ellos 133 (97.8%) afirmaron tener algún tipo de religión, 90% eran católicos; 126 (93%) oraban por lo menos una vez al día, 60 (44.4%) tenían orientación hacia religiosidad intrínseca, 46 (33.8%) hacia religiosidad extrínseca y 16 (11.8%) hacia religiosidad mixta. En 40 (29.4%) hubo algún tipo de disfunción familiar; 69 (50.7%) carecían de un adecuado soporte social. Los síntomas depresivos se vieron en 10 (7.3%) (EDG>5/15) y sólo 5 (3.7%) presentaban síntomas severos (EDG>10/15). El género masculino, la viudez y padecer una enfermedad crónica, fueron más frecuentes en adultos mayores con síntomas depresivos (p<0.05). Se observó que en la mayoría de adultos mayores con síntomas depresivos la oración no hacía parte de su vida diaria (p=0.03). Conclusiones: El género masculino, ser viudo y las enfermedades crónicas fueron más frecuentes en adultos mayores con síntomas depresivos.

Objective: To determine the prevalence of religious practice, family dysfunction and social support in older people with deppresive symptoms. Methods: A descriptive study was performed in La Selva Health Center (Cali, Colombia) during 2001. Measures used were depression (GDS-Yesavage Scale), intrinsic/extrinsic religiosity measurement (Gorsuch-McPherson), family APGAR (Smilkstein scale) and frequency of religious practice. Univariate and bivariate analyses were performed. Results: 136 subjects were recruited with an average age of 69.2±6.4 year old, 78 (57%) were male, 82 (60%) were married, 21 (15%) were widowers, 133 (97.8%) were believers or had religious practice; 90% were catholics, 126 (93%) of patients prayed at least once day, 60 (44.4%) had intrinsic religiosity, 46 (33.8%) extrinsic religiosity, and 16 (11.8%) mixed religiosity; 40 (29.4%) had family dysfunction, 69 (50.7%) had not an adequate social support; 10 (7.3%) had high depressive symptoms (GDS>5/15) and 5 (3.7%) had severe depressive symptoms (GDS>10/15). The presence of chronic diseases, and being a widower had more frequency in older people with deppresive symptoms (p<0.05). Most old subjects with depression had no regular religious practice (p=0.03). Conclussion: Male gender, presence of chronic diseases and being a widower had more frequency in old people with deppresive symptoms (p<0.05). Religious practice could be an important support for old patients’ health.

Nosocomial Infection of Lower Respiratory Tract in Old Patients: Investigation and Analysis / 中华医院感染学杂志

OBJECTIVE To find out about the situation of lower respiratory tract nosocomial infection in old patients . METHODS To investigate 237 cases with nosocomial infection of lower respiratory tract who were over 60 years old in our hospital. RESULTS People who were over 60 accounted for 85.25% among the cases with the nosocomial infection of lower respiratory tract, their death rate was 25.74%; in the results of pathogen culturing , Gram-negative bacilli occupied the main position which accounted for 57.81%. Pseudomonas aeruginosa accounted for 35.93% and fungi accounted for 21.88%, they were the two kinds of common pathogens. CONCLUSIONS The serious underlying diseases in old patients, their long hospital stays and weak immune function , large number of invasive diagnostic procedures and traumatic operation, and unreasonal use of antibiotics have made great distribution to nosocomial infection and influence to prognosis, it is necessary to take corresponding measures to settle them.

Giant Cell Tumor of the Temporal Bone in an Old Patient

We report a case of a 67-year-old woman with giant cell tumor of the temporal bone. A 67-year-old woman presented with localized tenderness, swelling, sensory dysesthesia, dizziness, and headache over the left temporal bone. She was neurologically intact except left hearing impairment, with a nonmobile, tender, palpable mass over the left temporal area. A brain computed tomography(CT) scans showed a relatively well defined heterogenous soft tissue mass with multiple intratumoral cyst and radiolucent, osteolytic lesions involving the left temporal bone. The patient underwent a left frontotemporal craniotomy and zygoma osteotomy with total mass removal. Permanent histopathologic sections revealed a giant cell tumor. She remains well clinically and without tumor recurrence at 2 years after total resection.

Analgesic Effect of Tramadol im for Old Patients after Thoracic Surgery / 中国药房

OBJECTIVE:To evaluate the analgesic efficacy and safety of tramadol im.on pain after thoracic surgery.MET_ HODS:34cases after thoracic surgery were given tramadol im.in a dose of1.5mg/kg.The analgesic effect and adverse effect were observed.RESULTS:The significant effective rate of pain relief was41.2%and effective rate was38.2%with a total effective rate of79.4%.Some adverse effects including temporary nausea,vomiting,perspiration,dysuria were observed in a part of the patients.No respiratory inhibition was found.CONCLUSION:Tramadol(1.5mg/kg)im.is safe and effective in treatment of the pain after thoracic surgery.

Clinical Effects of Levofloxacin in the Treatment of the Old Patients with Lower Respiratory Tract Infections / 中国药房

OBJECTIVE:To evaluate the clinical effect and safety of Levofloxacin(LVFX)in the treatment of the old pa?tients with lower respiratory tract infections.METHODS:Sixty-six old patients with lower respiratory tract infections were randomly divided into trial therapy group and the control group,receiving0.4g LVFX and0.4g Ofloxacin intravenous drip once a day for7～14days respectively.RESULTS:In the trial therapy group and the control group,the clinical effective rates were90.9%and66.7%(P0.05),adverse reaction rates were9.1%and33.3%(P

Eosinophilic Granuloma of Lumbar Spine in Old Patient: 1 Case Report / 대한척추외과학회지

Eosinophilic granuloma of bone is a self-limited condition, characteristically a disease of children and young adults. It is the most benign variant of histiocytosis X. It is most common in skull, but any bone may be affected. Vertebral involvement occurs in about 10 to 15%. This benign bone destructive lesion is characterized by the presence of Langerhans cells contain Birbeck granules, infilitration of histiocytes and eosinophilic leukocytes unknown origin. We report a eosinophilic granuloma in lumbar spine of old patient.

Study of blenderized diet on nutritional status in old patients / 肠外与肠内营养

Objectives:To observe the supporting effect of blenderized diet on the nulritional statusin the old patients. Methods:Twenty four patients were given blenderized diet made in our department as nutrition support.The nutritional assessments were preformed before and after the support. Results:The serum levels of albumin and phosphorus and the total lymphocyte count were increased after the support( P