RESUMO
BACKGROUND: Behavioral and psychological symptoms in dementia (BPSD) are a major concern. The French government gave a consensual definition of reinforced intermediate-term care units for BPSD within the project "Plan Alzheimer 2008/2012". OBJECTIVE: Our aim was to report one of the first experiences of this unit in France. RESULTS: Fifty-two patients (38 females, 14 males) were included, mean age 82.07±7.84 (73-97). About 80% of patients were improved and there was a high discharge rate to home of about 30%. Night-time behaviors, aberrant motor behaviors and agitation were the most frequent symptoms. CONCLUSION: Our study confirms that demented elderly patients greatly benefit from a specific BPSD care unit in agreement with the objective of Plan Alzheimer 2008/2012.
Assuntos
Demência/psicologia , Psiquiatria Geriátrica/organização & administração , Serviços de Saúde para Idosos/organização & administração , Unidades Hospitalares/organização & administração , Instituições para Cuidados Intermediários/organização & administração , Transtornos Mentais/etiologia , Idoso , Idoso de 80 Anos ou mais , Demência/tratamento farmacológico , Demência/reabilitação , Gerenciamento Clínico , Feminino , França , Serviços de Saúde para Idosos/legislação & jurisprudência , Humanos , Instituições para Cuidados Intermediários/legislação & jurisprudência , Masculino , Desnutrição/complicações , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/reabilitação , Alta do Paciente , Projetos Piloto , Agitação Psicomotora/etiologia , Psicotrópicos/uso terapêutico , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/etiologia , Resultado do TratamentoRESUMO
PURPOSE: Apple-peel atresia is a rare form of bowel atresia associating proximal jejunal atresia with a typical coil-shaped distal small bowel. Many of the children suffering from this condition are still managed with initial enterostomy followed by delayed anastomosis. PATIENTS AND METHOD: Between 2000 and 2007, we managed four patients with apple-peel atresia. Three by primary anastomosis and one by initial enterostomy with delayed anastomosis. RESULTS: Total duration of total parenteral nutrition (TPN) was an average 109 days. Survival rate was 100% with an average follow-up of 4.3 years. CONCLUSION: Nowadays, the prognosis of apple-peel atresia depends mainly on prolonged TPN-related morbidity rather than immediate postoperative complications. We therefore recommend that those infants affected be managed by primary anastomosis in order to reduce the duration of parenteral nutrition, followed by careful nutrition by teams experienced in neonatal TPN and short bowel syndrome.
