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OBJECTIVE@#To explore the prognostic factors affecting the primary surgical management of aged patients with cleft palate.@*METHODS@#This study reviewed aged patients with cleft palate who received Furlow palatoplasty (surgical age≥5 years) at the cleft center at West China Hospital of Stomatology from 2009 to 2014. The study retrieved intraoperative mea-surements, including velar length, pharyngeal depth, cleft width, maxillary width, cleft palate index, and palatopharyngeal ratio. Speech evaluation results at follow-up at least a year after surgery were also obtained. Logistic regression and retrospec-tive analyses were performed to identify correlative prognostic factors.@*RESULTS@#One hundred and thirty-one patients were included (70 males and 61 females). Dichotomy logistic regression analysis revealed that pharyngeal depth was the only mea-surement considerably associated with postoperative velopharyngeal function. Pharyngeal depth deeper than 16 mm indicated high risk of postoperative velopharyngeal insufficiency.@*CONCLUSIONS@#Pharyn-geal depth is a significant prognostic factor for the primary surgical management of aged patients with cleft palate. Pharyn-goplasty might be considered when planning the primary management of aged patients.
Subject(s)
Child, Preschool , Female , Humans , Male , China , Cleft Palate , Palate, Soft , Pharynx , Retrospective Studies , Treatment Outcome , Velopharyngeal InsufficiencyABSTRACT
Se realizó un estudio descriptivo y transversal de 45 cuidadores de adultos mayores hemipléjicos a causa de enfermedad cerebrovascular, atendidos en la Sala de Rehabilitación Integral del Policlínico Universitario Luis Augusto Turcios Lima del municipio y provincia de Pinar del Río, desde julio hasta diciembre de 2015, con vistas a caracterizar a dichos cuidadores según variables de interés para la investigación. En la serie prevalecieron los cuidadores de 50-59 años de edad (53,3 por ciento), del sexo femenino (44,4 por ciento), con nivel educacional preuniversitario (37,8 por ciento), con lazos de parentesco (71,1 por ciento) y con un tiempo en esta labor entre 7-9 meses (40,0 por ciento). El parentesco existente entre el cuidador y la persona cuidada es un factor importante que influye en gran medida en la experiencia del cuidado
A descriptive and cross-sectional study of 45 caregivers of aged hemiplegic adults with cerebrovascular disease, assisted in the Comprehensive Rehabilitation room of Luis Augusto Turcios Lima University Polyclinic in Pinar del Río municipality and province, was carried out from July to December of 2015, with the aim of characterizing this caretakers, according to variables of interest for the investigation. In the series the caregivers of 50-59 years of age (53,3 percent), the female sex (44,4 percent), preuniversity educational level (37,8 percent), family relationship (71,1 percent) and with a period in this activity among 7-9 months (40,0 percent) prevailed. The existent family relationship between the caregiver and the sick elderly is an important factor that influences greatly in the experience of the care
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged , Caregivers , Stroke , Hemiplegia , Primary Health Care , Epidemiology, Descriptive , Cross-Sectional Studies , Frail ElderlyABSTRACT
Se presenta el caso de un paciente de la tercera edad mostrando cuadro agudo sintomático con complicaciones cardiacas evidenciadas por detección de fibrilación auricular, miopericarditis, derrame pericárdico moderado, sin signos de taponamiento cardíaco, fracción de eyección del ventrículo izquierdo (FEVI) < 30% y aneurisma, detectados mediante estudios electro y eco cardiográficos, respectivamente. El despistaje parasitológico reveló la presencia de Trypanosoma cruzi en muestra de sangre circulante y líquido pericárdico, con hemocultivo positivo y detección de ADN específico del parásito por ensayos de PCR. Asimismo, la presencia de altos niveles de anticuerpos circulantes anti-T. cruzi detectados con dos pruebas serológicas (TAD, IFI) y la observación de altos niveles IgM, corroboran el diagnóstico de un cuadro de enfermedad de Chagas en fase aguda de la infección. Además, la procedencia del paciente de una localidad andina del occidente de Venezuela, donde la enfermedad de Chagas es endémica, unido al hallazgo de ejemplares adultos de triatominos en la vivienda del paciente confirman el diagnóstico. Se discute la significación del presente hallazgo y se detallan las observaciones durante la re-evaluación en el seguimiento post tratamiento.
A Clinical case from an aged patient with evidence of suffering heart failure showing arrhythmia, atrial fibrillation and pericarditis, pericardial effusion and left ventricle aneurism detected by electrocardiogram and echocardiogram respectively, is reported. Parasitological examination revealed presence of Trypanosoma cruzi in blood and pericardial fluid samples. In addition, hemoculture was positive and PCR assay revealed specific T. cruzi DNA. Serological techniques (DAT, IFAT) showed anti-T.cruzi circulating antibodies, including high level IgM. The sero-parasitological and molecular (PCR) findings confirmed the presumptive clinical diagnosis for Chagas disease acute infection. The significance of the present findings is discussed and clinical details observed during re-evaluation post-treatment, are included.
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Se realizó un estudio de evaluación de los recursos sociales en algunos ancianos ingresados en el Servicio de Geriatría del Hospital Universitario "Dr. Ambrosio Grillo Portuondo" de Santiago de Cuba, de enero a junio del 2010, para lo cual se les caracterizó conforme a las variables: edad, sexo y escolaridad, y se utilizó como instrumento de valoración la escala del cuestionario multidimensional de asesoramiento funcional. En la serie hubo similitud en cuanto al sexo, predominó el grupo etario de 60-69 años, la mayoría de los pacientes tenía grado de escolaridad primario, las relaciones sociales no eran satisfactorias, y los recursos sociales difirieron según el sexo y la edad. Se concluyó que la citada escala es un instrumento que ayuda a determinar con mayor precisión el deterioro de los recursos sociales de los ancianos; además constituye un aporte social, porque sobre la base de lo obtenido en su aplicación se pueden realizar estrategias comunitarias y así mejorar el cuidado a este grupo poblacional.
An evaluation study of the social resources in some aged patients at the Geriatrics Service of "Dr. Ambrosio Grillo Portuondo" Teaching Clinical Surgical Hospital in Santiago de Cuba was carried out from January to June, 2010, for which they were characterized according to the variables: age, sex and school level, and the scale of the multidimensional questionnaire of functional advice was used as instrument of evaluation. In the series there was similarity as for sex, the age group 60-69 year prevailed, most of the patients had primary school level, social relations were not satisfactory, and the social resources differed according to sex and age. It is concluded that the mentioned scale is an instrument which helps to determine with greater precision the deterioration of the social resources of the aged patients; it also constitutes a social contribution, because on the base of what is obtained in its application community strategies can be carried out and in this way the care to this populational group improves.
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Oral anticoagulant therapy is generally being used in patient with a high thromboembolic risk such as cerebrovascular or cardiovascular accident, in spite of increased bleeding tendencies and most of them are old-age patients. A stroke frequently leads to a fall, which in turn causes a minor trauma, and it is often reported that anticoagulant therapy for treatment of stroke may aggravate traumatic brain injury. The authors report a case that required surgical treatments for subacute subdural hematoma which was found during antiplatelets and anticoagulant therapy for acute ischemic stroke. The hematoma had not been found at the time of head injury accompanied by a cerebral infarction.
Subject(s)
Humans , Brain Injuries , Cerebral Infarction , Craniocerebral Trauma , Hematoma , Hematoma, Subdural , Hemorrhage , Stroke , WarfarinABSTRACT
Oral anticoagulant therapy is generally being used in patient with a high thromboembolic risk such as cerebrovascular or cardiovascular accident, in spite of increased bleeding tendencies and most of them are old-age patients. A stroke frequently leads to a fall, which in turn causes a minor trauma, and it is often reported that anticoagulant therapy for treatment of stroke may aggravate traumatic brain injury. The authors report a case that required surgical treatments for subacute subdural hematoma which was found during antiplatelets and anticoagulant therapy for acute ischemic stroke. The hematoma had not been found at the time of head injury accompanied by a cerebral infarction.
Subject(s)
Humans , Brain Injuries , Cerebral Infarction , Craniocerebral Trauma , Hematoma , Hematoma, Subdural , Hemorrhage , Stroke , WarfarinABSTRACT
OBJETIVO: Relatar o manejo de um caso de fissura labiopalatina transforame, unilateral, em paciente idoso. MÉTODO: Utilizou-se a técnica de Millard associada à rinosseptoplastia. RESULTADO E DISCUSSÃO: O resultado obtido foi bastante satisfatório. Entretanto, a existência de um idoso comfissura labiopalatina não tratada em pleno terceiro milênio mostra que ainda há muito que avançar em relação à política de atenção aos pacientes com anomalias craniofaciais.
OBJECTIVE: To present the surgical treatment of an elderly patient with untreated cleft lip/palate. METHOD: The Millard´s surgical technique was chosen for the correction of the lip and nose defects. RESULTS AND DISCUSSION: The achieved results of the surgicaltreatment were satisfactory. However, the existence of an untreated aged patient in the third millennium shows that there is still much to advance in the attention policy of patients with craniofacial anomalies.
Subject(s)
Humans , Male , Aged , Cleft Lip/therapy , Cleft Palate/therapy , Rhinoplasty , Nasal Septum/surgery , Surgery, PlasticABSTRACT
OBJETIVO: este artigo tem como objetivo abordar as características do tratamento ortodôntico associado a uma atuação odontogeriátrica, pois devido a um aumento da expectativa de vida, um maior número de pacientes idosos tem procurado tratamento odontológico para uma reabilitação estética e/ou funcional. METODOLOGIA: através de uma avaliação de dados presentes na literatura são abordados fatores como enfermidades sistêmicas, uso de medicamentos, condição da saúde bucal, quantidade de osso alveolar, motivação do paciente e estabilidade oclusal após a terapia ortodôntica. Para exemplificar o tratamento ortodôntico no paciente idoso são apresentados dois casos clínicos. CONCLUSÕES: o tratamento ortodôntico representa uma intervenção viável na atuação odontogeriátrica, desde que realizado com forças suaves, considerando as limitações de cada caso e respeitando as características inerentes a esta atuação.
OBJECTIVE: to approach the characteristics of the orthodontic treatment in aged patients, because the increase of life expectancy resulted in a bigger number of these kind of patients looking for orthodontic treatment. METHODS: an evaluation of the literature show a series of factors as: systemic disease, medicine utilization, condition of the buccal health, amount of alveolar bone, patients' motivations and occlusal stability after the orthodontic therapy. To demonstrate the orthodontic treatment in the aged patient two clinical cases are presented. CONCLUSIONS: the orthodontic treatment represents a viable intervention in the aged patients, since that carried through with soft forces, considering the limitations of each case and respecting the inherent characteristics to these patients.
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Humans , Female , Aged , Geriatric Dentistry , Orthodontics , Life Expectancy , Health of the ElderlyABSTRACT
0.05).No sign of aseptic loosening or change in implant position was noted.[Conclusion]This short-term study showed that bipolar femoral head arthroplasty seems to be a suitable alternative for primary treatment of displaced femoral neck fractures in patients over 80 years.More attention should be paid to coexisting medical illness(e.g.diabetes mellitus,hypertension,and ischaemic heart disease)and prevention of complications.
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Objective To study the feasibility and safety for using anesthesia gastroscopy in aged-patients over 80 years old.Methods Selecting 84 cases of aged-patients over 80 years old as anesthesia group(group 1),22 cases of aged-patients over 80 years old as normal gastroscopy group(group 2)and 100 cases of young-middle age as anesthesia control group(group 3).Low dose propofol and fentanyl combined atropine were injected into venous in anesthesia gastroscopy.The BP,HR,SpO2,patients reactions during gastroscopy,stomach peristalsis rates,awake time were detected before,during and after gastroscopy.Results Patients in group 1 felt much less discomfortable than those in group 2.Anesthesia group felt much satisfactorily than normal gastroscopy group.The BP,HR,SpO2 in group 1 were decreased transitorily during examination and resumed rapidly after examination.There were no severe complications in anesthesia gastroscopy.However,the BP and HR were increased obviously in normal gastroscopy group.The dosage of propofol in group 1 was much less than that in group 3.Conclusions The use of anesthesia gastroscopy with low dose propofol and fentanyl combined atropine intravenously in aged-patients over 80 years old is safe and comfortable.
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Objective To summarize the experience of anesthesia management of retroperitoneoscopic surgery in aged patients(aged more than 70 years old).Methods The clinical data of 81 aged patients(ranged from 70 to 86 years old,mean:74.2 years old)receiving retroperioneoscopic surgery from October 2002 to January 2007 was reviewed retrospectively in our hospital.Of whom,77 patients had concomitant diseases.81 patients were operated on under general anesthesia.Results Hypercarbia,acidosis and hypertension occurred in 35(43.2%),35(43.2%) and 41(50.6%) cases,respectively,after pneumoperitoneum.Tracheal catheters were pulled out in 66 patients in operation room,with the decannulation time being 5-50 minutes(mean,15.1 minutes).14 patients(17.3%) were transferred to ICU postoperatively.1 patient(1.2%) died from acute myocardial infarction.Sever delirious state was found in 1 patient.Conclusions On the basis of cautious perianesthesia management,aged patients can tolerate hypercapnia,acidosis and elevation of blood pressure induced by pneumoperitoneum,but the management of perianesthesia period should be prudent.
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Objective: To explore the preventive measures for early stage pulmonary complications in old patients following thoracic surgery.Methods: We conducted psychotherapy,pulmonary infection control,training in breathing and instructions in expectorating phlegm in 127 old patients(over 70 years) undergoing thoracic surgery.Results: The patients experienced difficult expectoration on the first postoperative day because of increased sputum viscoelasticity,which was gradually improved later.Analgestic and mucokinetic measures produced intended results on the first three postoperative days,with significant improvement of sputum fluidity.And the concept of fast track surgery promoted the recovery of the patients.Conclusion: The preventive measures proved essential for the prevention of early stage pulmonary complications in old patients following thoracic surgery.
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OBJECTIVE:To evaluate the sedative and analgesic effects and safty of fentanyl-propofol and midazolam-propofol by intravenous injection in gastroscopy for aged-patients.METHODS:128aged-patients were randomly divided into3groups:fentanyl-propofol group(groupⅠ),midazolam-propofol group(groupⅡ)and ordinary gastroscopy group(groupⅢ).The effects of sedation and analgesia and the variation of SBP,HR and SDNN were observed.RESULTS:Patients in groupⅠandⅡfelt much less discomfortable than those in groupⅢ(P
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Objectives: The aim of this study was to define whether growth hormone therapy would reduce the course of postoperative fatigue (POF) in aged patients (60～80 years old) with nutritional support. Methods: Forty aged patients who underwent partial gastrectomy or other operations were randomized into two groups. All patients were treated with the same nutritional support formula.A group of patients was treated with rhGH for 7 day from the third day after operation, and control group treated with placebo.The score of POF, nitrogen balance, transferrin level and body weight were monitored. Results: Score of POF in rhGH group on day 7 and 14 after operation was lower than that in control group(P0.05). Conclusions: Aged patients with rhGH after major operation can recover more rapidly from POF.
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OBJECTIVE To investigate the distribution and antimicrobial susceptibility of clinical isolates from the aged patients with urinary tract infection.METHODS Totally 1211 strains of germs were identified and(susceptibility) tests were performed using VITEK-60 system as recommended by the manufacturer.RESULTS The most common pathogens were Escherichia coli,Klebsiella pneumoniae,and Enterococcus faecalis.The infective rate of fungi was higher in the elderly.CONCLUSIONS Our data will be useful for reasonably choosing(antimicrobial) agents in(treatment) of UTI in the aged.
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Objective To discuss the indications,technical skills and the therapeutic effects of percutaneous lumbar diskectomy(PLD) for the treatment of lumbar intervertebral disc herniation in patients over 70 years.Methods From August 2004 to July 2008,PLD was performed in 48 patients(aged 70-79) with lumbar intervertebral disc herniation.A total of 58 lumbar intervertebral disc herniations were detected,all of which were encapsulated intervertebral disc herniation.Fifty-two patients,who showed similar symptoms,signs and same imaging manifestations and were 70-81 years old,were randomly selected as control group to receive conservative treatment.Results Of 56 lumbar intervertebral disc herniations,54 were successfully punctured with a successful rate of 96.4%.All patients were followed up.The excellent rate and the effective rate at 6 months were 29.1% and 52.1% respectively for PLD group,while that were 19.2% and 36.5% respectively for control group.The excellent rate and the effective rate at 12 months were 25.0% and 47.9% respectively for PLD group,while that were 17.3% and 32.7% respectively for control group.At both 6 and 12 months after the treatment,the therapeutic effects of PLD group were significantly better than that of control group,the difference were statistically significant(?2=7.45,P