Home About us Contact
|
Home About us Contact | ||
|
|
||
Many Elderly Patients (many + elderly_patient)
Selected AbstractsValidation of video versus electromyography for chewing evaluation of the elderly wearing a complete dentureJOURNAL OF ORAL REHABILITATION, Issue 8 2007E. NICOLAS summary, Chewing efficiency may affect nutritional status in the elderly. Many elderly patients are complete denture wearers, and often present cognitive problems. Those two factors make evaluation of mastication difficult with experimental methods. Analysis of video recording may be a simple way to routinely assess chewing parameters. This study aimed at validating several parameters of video evaluation versus electromyography (EMG), which is considered the ,gold standard'. The design was a prospective randomized study, carried out at the Faculty of Dentistry, University of Auvergne, Clermont-Ferrand, France. Twelve complete denture wearers chewed four model foods differing in hardness. Sessions were videotaped and EMG recordings were registered. Mastication time, number of masticatory cycles and cleaning time were recorded simultaneously by video and EMG. Two investigators independently analyzed the videos twice, in random order. Evaluation of criterion validity: a positive video/EMG correlation was found for the parameters ,chewing time' (0·89, Pearson) and ,number of masticatory cycles' (0·94, Spearman), whereas no statistical difference was found between these two EMG and video variables (t -test). Inter and intra-rater reliability gave a positive intraclass coefficient (ICC) for duration of mastication (0·86,0·98), number of masticatory cycles (0·90,0·97) and cleaning time (0·90,0·98). Discriminatory ability was studied using anova (P = 0·01): variation was significant in masticatory duration (F = 10), number of masticatory cycles (F = 10) and cleaning time (F = 4). Video may be a useful assessment tool in prosthetic rehabilitation and can be applied to help choose the type of food (solid, semi-liquid or liquid) to administer to dependent persons, particularly those suffering from dementia. [source] Leg clubs: A new approach to patient-centred leg ulcer managementNURSING & HEALTH SCIENCES, Issue 3 2000DNCERT, DipHE, Ellie Lindsay BSC(HONS) Abstract Loneliness is a significant health-care issue for many elderly patients in the community. The correlation between social isolation, poor compliance to treatment, and low healing rates for patients suffering from leg ulcers is well documented. Pain, odour, bandages etc. contribute to low self-esteem, depression and social stigma. Home visits by community nurses cannot provide the social and psychological support required by these patients. Responding to the holistic needs of this client group, the author set up Debenham Leg Club in 1995 to provide leg ulcer management in an informal, non-medical setting, where the emphasis is on social interaction, participation, empathy and peer support. This social model was conceived as a unique partnership between the district nurses and the local community, in which patients are empowered, through a sense of ownership, to become stakeholders in their own treatment. The value of the ,club' concept is evident in the happy, welcoming, uninhibited atmosphere that characterizes the clinic. Non-compliance to treatment has been virtually eliminated and evidence of greater healing rates has been illustrated through many patients whose long-standing ulcers have healed or greatly improved as a direct result of this change in approach. Patients' willingness to attend for systematic ,well leg' checks and ongoing health education has dramatically reduced the incidence of recurrence. [source] Herpes zoster in older adults. (Duke University Medical Center, Durham, NC) Clinical Infectious Diseases.PAIN PRACTICE, Issue 4 20011486., 2001;32:148 Herpes zoster (HZ) strikes millions of older adults annually worldwide and disables a substantial number of them via postherpetic neuralgia (PHN). Key aged-related clinical, epidemiological, and treatment features of zoster and PHN are reviewed in this article. HZ is caused by renewed replication and spread of the varicella-zoster virus (VZV) in sensory ganglia and afferent peripheral nerves in the setting of age-related, disease-related, and drug-related decline in cellular immunity to VZV. VZV-induced neuronal destruction and inflammation causes the principal problems of pain, interference with activities in daily living, and reduced quality of life in elderly patients. Recently, attempts to reduce or eliminate HZ pain have been bolstered by the findings of clinical trials that antiviral agents and corticosteroids are effective treatment for HZ and that tricyclic antidepressants, topical lidocaine, gabapentin, and opiates are effective treatment for PHN. Although these advances have helped, PHN remains a difficult condition to prevent and treat in many elderly patients. Comment by Miles Day, M.D. This article reviews the epidemiology clinical features diagnosis and treatment of acute herpes zoster. It also describes the treatment of postherpetic neuralgia. While this is a good review for the primary care physician, the discussion for the treatment for both acute herpes zoster and postherpetic neuralgia do not mention invasive therapy. It is well documented in pain literature that sympathetic blocks with local anesthetic and steroid as well as subcutaneous infiltration of active zoster lesions not only facilitate the healing of acute herpes zoster but also prevents or helps decrease the incidence of postherpetic neuralgia. All patients who present to the primary care physician with acute herpes zoster should have an immediate referral to a pain management physician for invasive therapy. The treatment of postherpetic neuralgia is a challenging experience both for the patient and the physician. While the treatments that have been discussed in this article are important, other treatments are also available. Regional nerve blocks including intercostal nerve blocks, root sleeve injections, and sympathetic blocks have been used in the past to treat postherpetic neuralgia. If these blocks are helpful, one can proceed with doing crynourlysis of the affected nerves or also radio-frequency lesioning. Spinal cord stimulation has also been used for those patients who are refractory to noninvasive and invasive therapy. While intrathecal methylprednisolone was shown to be effective in the study quoted in this article one must be cautious not to do multiple intrathecal steroid injections in these patients. Multilple intrathecal steroid injections can lead to archnoiditis secondary to the accumulation of the steroid on the nerve roots and in turn causing worsening pain. [source] Percutaneous Intervention of Superior Mesenteric Artery Stenosis in Elderly PatientsCLINICAL CARDIOLOGY, Issue 5 2009Neelima Penugonda MD This review article focuses on stent placement in mesenteric arteries in older patients with an increasingly common diagnosis of chronic mesenteric ischemia (CMI). We reviewed the articles that focused on the treatment of this gastrointestinal disorder by stenting/open surgical revascularization to avoid further ischemic episodes and bowel infarction and necrosis. The advantages of stent placement in mesenteric arteries are discussed in comparison to open surgical revascularization. In summary, the low morbidity and high technical success rate of catheter-based techniques have made this approach the first line of therapy for CMI due to superior mesenteric artery stenosis for many elderly patients especially high-risk operative candidates. Copyright © 2009 Wiley Periodicals, Inc. [source] | ||||||||||