ABSTRACT
Objective To explore the characteristics of pathogenic bacteria and risk factors for stroke‐associated pneumonia (SAP) in senile patients in order to privide basis for early clinical intervention .Methods A retrospective study was carried out to review the clinical data of 689 SAP patients treated at a university hospital between January 1 ,2011 and December 12 ,2013 . The pathogens from sputum and their antibiotic resistance profiles were analyzed .Multivariate Logistic regression model was used to screen relevant factors for stroke‐associated pneumonia (SAP) in a case‐control analysis at 1∶1 ratio .Results Of the 684 bacterial strains isolated from sputum , 545 (79 .7% ) were gram‐negative bacteria . The top bacterial species were Pseudomonasaeruginosa,Klebsiellapneumoniae,Acinetobacterbaumannii,and Enterobacterspp.Gram‐negativebacteria were highly resistant to most of the antimicrobial agents . About 31 .8% of the Acinetobacter strains were resistant to imipenem .A total of 139 (20 .3% ) gram‐positive strains were isolated . Staphylococcus aureus was the most frequently isolated gram‐positive pathogen (51 .8% ) , of which 63 .9% were resistant to methicillin (MRSA) .Most gram‐positive bacteria were sensitive to vancomycin , teicoplanin and linezolid . Multivariate Logistic regression suggested that age ( OR = 5 .632 ) , NIH stroke scale (NIHSS) score (OR= 4 .126) ,dysphagia (OR= 3 .481) , totally bedridden (OR=3 .431) ,mechanical ventilation (OR=4 .214) ,hyperglycemia (OR=2 .076) ,hypoalbuminemia (OR=2 .008) ,and high serum cortisol (OR=1 .825) were the major risk factors for SAP in senile patients .Conclusions Multiple antibiotic‐resistant pathogens are usually identified in the senile SAP patients .Early intervention to control the risk factors of SAP is important for prevention of SAP in senile patients .
ABSTRACT
Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment while the other factor scores were not significantly changed.Trazodone wes effective without severe side effects and dependence.The study group showed significantly lower scores in learning,calculation,the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive function than after treatmemt (P ＜ 0.05 ).Conclusion Trazodone is an ideal medicine to senile insomnia.
ABSTRACT
[Objective]To discuss a reasonable treatment for unstable intertrochanteric hip fractures in senile patients by comparing the effects of PFN fixation and hemiarthroplasty.[Method]Totally 82 intertrochanteric hip fractures in senile patients with complete clinical data were retrospectively analyzed,who were treated with hemiarthroplasty or PFN fixation from April 2005 to April 2007.Forty-six were treated with hemiarthroplasty,36 were treated with PFN fixation.All of them had multiple medical co-morbidities.According to modified Evens-Jensen classification,all of them belonged to unstable fracture.Comparison was made between the two treated groups in terms of the length of incision,operative time,the blood lost,blood transfusion during or after surgery,time for bed rest postoperatively,postoperative complications and St.Michael hip score one year after surgery.[Result]The average duration of follow-up for PFN fixation and hemiarthroplasty were 16 and 18 months respectively.Compared with the group of hemiarthroplasty,the group of PFN fixation experienced longer operation time,longer time for bed rest postoperatively,less blood lost,less blood transfusion during or after surgery,shorter incision length,and the differences between two groups had statistical significance (P0.05).[Conclusion]Both of the two methods are reasonable treatment for unstable intertrochanteric hip fractures in senile patients.
ABSTRACT
[Objective]To discuss a reasonable treatment for unstable intertrochanteric hip fractures in senile patients by comparing the effects of hemiarthroplasty and DHS fixation.[Method]Totally 126 intertrochanteric hip fractures in senile patients with complete clinical data were retrospectively analyzed,who were treated with hemiarthroplasty or DHS fixation from June 2002 to October 2005.Of the 126 patients,53 were treated with hemiarthroplasty,73 were treated with DHS fixation.All of them had multiple medical co-morbidities and were combined with severe osteoporosis.According to modified Even-Jensen classification,all of them belonged to unstable fractures.Comparison was made between the two treated groups in terms of operative time,blood transfusion during or after surgery,time for bed rest postoperatively,postoperative complications and St.Michael hip score one year after surgery.[Result]The average duration of follow-up for hemiarthroplasty and DHS fixation was 16 and 18 months respectively.Compared with the group of DHS fixation,the group of hemiarthroplasty experienced shorter time for bed rest postoperatively,fewer postoperative complications and higher St.Michael score 1 year after surgery,and the differences between two groups had statistical significance(P0.05).[Conclusion]Cemented hemiarthroplasty has the advantages of allowing early full weight bearing after surgery,low complication rate and satisfactory functional recovery.It is a reasonable treatment for unstable intertrochanteric hip fractures in senile patients.
ABSTRACT
OBJECTIVE To investigate the spread status and drug-resistance of pathogenic bacteria causing chronic bacterial prostatitis among the senile patients,and provide the reference for clincal diagnosis and treatment.METHODS Prostatic fluid from the senile patients with chronic bacterial prostatitis was collected,and bacterial cultures and susceptibility tests were performed.The data were analyzed statistically.RESULTS Among 216 prostatic fluid specimens from the senile patients with chronic bacterial prostatitis,140 isolates of pathogenic bacteria were detected.In these strains,Gram-positive cocci accounted for 60.0% and most of them were Staphylococcus aureus.Gram-negative bacilli accounted for 40.0% and most of them were Escherichia coli.Pathogens causing prostatitis have been resistant to the common antibiotics.Among the total staphylococci,meticillin-resistant Staphylococcus(MRS) accounted for 34.8%.And among the total Enterobacteriaceae,ESBLs producing bacteria accounted for 35.6%.CONCLUSIONS Chronic bacterial prostatitis in the senile patients possesses intractability and persisting.It is important to monitor the pathogens and their drug-resistance.
ABSTRACT
Stenotrophomonas maltophilia.At the same time 136 strains of fungi were isolated.Candida albicans was the most predominant accounted for 60.3%.50.7% Strains of K.pneumoniae and 75.7% strains of E.coli produced ESBLs.The resistance rates of all K.pneumoniae and E.coli to ?lactams were above 50%.All isolates of Enterobacteriaceae were sensitive to imipenem or meropenem.The activity of antibacterial agents against P.aeruginosa was coming down. CONCLUSIONS K.pneumoniae and E.coli are the major pathogens in senile patients with lower respiratory tract infection.Increasing of nonfermenters and fungi as an infection should bring great concern.
ABSTRACT
OBJECTIVE To explore the prevention mesures of hospital infection in aged patients with long-term central vein catheterization.METHODS The clinical data of 26 aged patients with long-term central vein catheterization from Mar 2005 to Oct 2006 were analyzed retrospectively.RESULTS Among 26 aged patients with long-term central vein catheterization,no related hospital infection occurred with average 7 d hospitalization.Swelling in upper extremities was observed in 5 patients.CONCLUSIONS The mesures,such as aseptic procedure for changing transfusion device periodically and using effective filter can effectively prevent the infection.
ABSTRACT
OBJECTIVE To provide more evidence for hospital infection control.METHODS To(analyze) the clinical records of the hospital-acquired pneumonia(HAP) of senile patients in department of(neurology) during Jan 2004 to Dec 2005 retrospectively.RESULTS There were 109 person-times(145 cases) senile(patients) with hospital(infection) during the two years.From them 77 cases were hospital-acquired infection,32 cases were ventilator-(associated) pneumonia(VAP),the infection rate was 22.1%.CONCLUSIONS The infection of HAP in department of neurology may induce by several factors.The key point to control HAP is prospective monitoring hospital(infection) in time,and taking effective measures to prevent the hospital infection on the basis of treatment the(underlying) disease.
ABSTRACT
Objective: To evaluate the effect and safety of continuous veno-venous hemofiltration(CVVH) in the treatment of multiple organ failure(MOF) in senile patients.Methods: Sixteen patients with multiple organ failure,aged over 80 years,were divided into a survival group,who lived more than 20 days,and a non-survival group,less than 20 days after CVVH,and observed for such clinical indexes as of renal function,K+and blood gas analysis,APACHEⅡ scores and complications.Results: After CVVH,eleven of the patients survived for over 20 days,with 1 case up to 3 years.CVVH effected a significant improvement in BUN,Scr,K+and blood gas as well as a marked reduction in complications.APACHE Ⅱ scores decreased significantly after CVVH in the survival group though not in the non-survival group,as compared with those before CVVH,which were significantly lower in the former than in the latter.Conclusion: CVVH is a safe,effective and well-tolerated method for the treatment of MOF in senile patients.Patients with higher APACHEⅡscores have a poor prognosis.
ABSTRACT
Objective To evaluate the efficacy and the toxicity of 89Strontium( 89 Sr) radionuclide therapy for the senile patients with bone metastatic cancer, and study the effects of 89 Sr on the image of bone metastasis, and to assess the utility of 89 Sr treatment for the senile patients in rehabilitation. Methods The effect on pain relief and the side effects of 27 senile patients with bone metastatic cancer were observed. The bone SPECT image was compared between those before and after the treatment, blood routine and blood biochemistry was tested. Results The total response rate was 70.4%, while the response rate of bone metastasis originated from prostatic cancer and breast cancer was 78.9%. A few metastasis sites in bone image disappeared or the concentration in the image became weak. A mild reversible harm to bone marrow function was the main side effect. 89 Sr had a little effect on blood biochemistry. Conclusion Radionuclide therapy with 89 Sr was an effective and well-tolerated method for the senile patients with bone metastatic cancer, which was a novel approach for pain-relief and rehabilitation of senile patients with bone metastatic cancer.
ABSTRACT
This article discusses the ethical problems about Senile patients of dermatosis and venereal disease in the diagnosis and treatment.The problems mainly include:(1)moral responsibility is not strong and skills are not taken into account when inquiring history;(2)it is not careful enough and personality of patients may be hurt when making medical examination;(3)attitude is not solemn and operation not normative;(4)treatment is not normative and charcteristics of senile patients are not considered.We bring forward some suggestions including of:(1)moral responsibility must be strong enough and skills should be taken into account when inquiring history;(2)it must be careful engough and personality of patients may be respected when making medical examination;(3)attitude must be solemn and operation must be normative;(4)characteristics of senile patients must be considered and treatment should be reasonable;(5)life of senile patients should be respected and cherished,the quality of life should be attached importance to:
ABSTRACT
We examined the clinical usefulness of Hachimi-jio-gan and other Kampo drugs for the senile patient suffering from gonarthrosis. Kampo drugs were administered referring not only to “Sho”but also roentgenograph of the knee joint. Hachimi-jio-gan was effective for the senile patients with gonarthrosis, while application of the “Seinetu-Risuizai”, drugs which clear away heat-evil and promote diuresis, were required in cases accompanied by excessive pathogenic dampness-heat combination, swelling and deformity of the Knee joint. Kampo drugs for senile patients are extremely useful because they have few side effects and provide high quality healing.
ABSTRACT
OBJECTIVE:To study the relation between mycotic superinfections and use of antimicrobials in senile patients.METHODS:106 senile in-patients who had mycotic superinfections following administration of antimicrobials were retrospectively analysed.RESULTS:Most of the senile patients over 60 years of age had severe underlying diseases and hypoimmunity and needed staying hospital for long time.Antimicrobial-induced mycotic superinfection played an important role in leading to mycotic infection in hospital accounting for 84.6% of total mycotic infections in our hospital during the corresponding period.Pulmonary infection was the commonest one and urinary tract infection the next.CONCLUSION:Long-term use of broad-spectrum antimicrobials is the main contributing factor resulting in increase of mycotic superinfections of senile patients in hospital.
