Nutritional Support of the Elderly in the UK

2015 ◽  
pp. 176-179
Author(s):  
Louise Davies
Keyword(s):  
Nutritional Support ◽  
The Elderly ◽  
The Uk

Approaches to common conditions of the gastrointestinal tract in pet hamsters

2021 ◽  
Vol 26 (3) ◽  
pp. 20-26
Author(s):  
Vicki Baldrey
Keyword(s):  
Nutritional Support ◽  
Gastrointestinal Disease ◽  
Parasitic Infection ◽  
Positive Contrast ◽  
Abdominal Ultrasound ◽  
Gastrointestinal Diseases ◽  
Indications For Surgery ◽  
Pet Trade ◽  
Free Environment ◽  
The Uk

Hamsters are popular pets in the UK. The Syrian or Golden hamster (Mesocricetus auratus) is the best known species in the pet trade, with a variety of dwarf species also encountered. Gastrointestinal disease occurs frequently, and diarrhoea is a common presenting complaint. This is most often associated with bacterial or parasitic infection, but can also be related to neoplasia or the use of certain antibiotics. Initial stabilisation of the hamster with diarrhoea should include provision of a warm stress-free environment, fluid therapy, nutritional support with an appropriate critical care diet and analgesia. Following a full history and clinical examination, further diagnostic steps include faecal parasitology and microbiology, routine biochemistry and haematology, radiography with or without positive contrast, and abdominal ultrasound. Indications for surgery include evidence of intestinal obstruction or prolapsed intussusception. This article gives an overview of the most common gastrointestinal diseases encountered in hamster species and provides a guide of how to logically approach the investigation and treatment of these cases, achievable in general practice.

scholarly journals Re-Admissions Following Hip Fracture Surgery

2009 ◽  
Vol 91 (7) ◽  
pp. 591-595 ◽  
Author(s):  
James Hahnel ◽  
Hannah Burdekin ◽  
Sanjeev Anand
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
The Elderly ◽  
Index Admission ◽  
Study Cohort ◽  
Rehabilitation Care ◽  
Hip Fracture Surgery ◽  
Fatal Adverse Events ◽  
The Uk ◽  
Fracture Surgery

INTRODUCTION Hip fractures in the elderly are a growing problem with a predicted incidence of 117,000 cases per year by 2016. Re-admission following a healthcare episode is an important outcome measure, which reflects non-fatal adverse events and indicates the natural history of disease. The purpose of this observational, multicentre audit was to examine rates and reasons for re-admission following hip fracture, to identify areas in the index admission and rehabilitation care that could be improved to prevent re-admission. PATIENTS AND METHODS A total of 535 patients (> 65 years old) in two district general hospitals in the UK who underwent hip fracture surgery were recruited into the study. RESULTS Of the study cohort, 72 patients (13.5%) died during their index admission and 88 (19.0%) of 463 patients were re-admitted once within 3 months. Causes of re-admission were attributed to medical (54.8%), failure to rehabilitate (23.8%), orthopaedic (19.0%) and surgical (2.4%) reasons. Infection was the most common (31.0%) reason for re-admission and arguably the most treatable. During the 3-month postoperative period, the mortality rate was 21.3%, increasing in those re-admitted to 35.1% representing the frailty of this group of patients. CONCLUSIONS High rates of re-admission are seen following discharge in elderly patients with hip fractures. Re-admitted patients have high mortality rates. Understanding causes of re-admission may help to reduce this burden.

New coronavirus infection COVID-19: how do we feed the sick?

2021 ◽  
Author(s):  
И.Н. Пасечник ◽  
А.А. Щучко ◽  
В.В. Сазонов ◽  
Т.Б. Иванова
Keyword(s):  
Nutritional Status ◽  
European Society ◽  
Nutritional Support ◽  
Clinical Nutrition ◽  
Comprehensive Treatment ◽  
Rehabilitation Programs ◽  
Number Of Patients ◽  
Coronavirus Infection ◽  
The Uk

Повышение качества оказания помощи больным новой коронавирусной инфекцией COVID-19 возможно только на основе мультидисциплинарного подхода. Оценка пищевого статуса и при необходимости его коррекция являются важной составляющей комплексных программ лечения и реабилитации таких больных. Значительное число пациентов с COVID-19 составляют люди пожилого и старческого возраста, у которых уже есть признаки нутритивной недостаточности. Нарушения питания и сопутствующая им саркопения – факторы риска неблагоприятного течения COVID-19. Прогрессирование саркопении при COVID-19 объясняют возникновением вирусного миозита, миопатией, спровоцированной цитокинами, и иммобилизацией. Уменьшение мышечной массы ассоциировано с плохим прогнозом заболевания и снижением качества жизни. Коррекция нарушений пищевого статуса больных COVID-19 должна проводиться на всех этапах лечения. Важность проблемы нутритивной поддержки отражена во множестве публикаций, посвященных лечению больных COVID-19. Необходимо заметить, что Европейское общество клинического питания и метаболизма (European Society for Clinical Nutrition and Metabolism, ESPEN) в кратчайшие сроки выпустило рекомендации по нутритивной поддержке больных новой коронавирусной инфекцией, что лишний раз подчеркивает актуальность проблемы. Это стало логичным продолжением рекомендаций по коррекции пищевого статуса больных, находящихся на лечении в отделении реанимации и интенсивной терапии. Аналогичные клинические рекомендации были разработаны в Великобритании, Бразилии и целом ряде других стран. Использование препаратов для перорального дополнительного питания в большинстве случаев позволяет обеспечить потребности пациентов в необходимых нутриентах, уменьшить выраженность саркопении и повысить эффективность реабилитационных мероприятий. Improving the quality of care for patients with the new coronavirus infection COVID-19 is possible only on the basis of a multidisciplinary approach. Evaluation of nutritional status and, if necessary, its correction are an important component of comprehensive treatment and rehabilitation programs for such patients. A significant number of patients with COVID-19 are elderly and senile people who already have signs of nutritional deficiency. Eating disorders and accompanying sarcopenia are risk factors for the adverse course of COVID-19. The progression of sarcopenia in COVID-19 is explained by the occurrence of viral myositis, myopathy provoked by cytokines, and immobilization. Decreased muscle mass is associated with poor disease prognosis and reduced quality of life. Correction of nutritional disorders in patients with COVID-19 should be carried out at all stages of treatment. The importance of the problem of nutritional support is reflected in many publications devoted to the treatment of patients with COVID-19. It should be noted that the European Society for Clinical Nutrition and Metabolism (ESPEN) promptly issued recommendations on nutritional support for patients with new coronavirus infection, which once again emphasizes the urgency of the problem. This was a logical continuation of the recommendations for correcting the nutritional status of patients undergoing treatment in the intensive care unit. Similar clinical guidelines have been developed in the UK, Brazil and a number of other countries. The use of drugs for oral supplementary nutrition in most cases allows to meet the needs of patients for the necessary nutrients, to reduce the severity of sarcopenia and to increase the effectiveness of rehabilitation measures.

scholarly journals A rude awakening: post-take ward round in the department of medicine for the elderly

1998 ◽  
Vol 91 (9) ◽  
pp. 471-474 ◽  
Author(s):  
Nicholas Coni
Keyword(s):  
Internal Medicine ◽  
General Practitioners ◽  
General Internal Medicine ◽  
Teaching Hospital ◽  
The Elderly ◽  
Ward Round ◽  
Younger Patients ◽  
General Internal ◽  
Ward Rounds ◽  
The Uk

This paper describes the post-take ward round of a department of medicine for the elderly (DME), to portray the nature of the medical admissions and their immediate management. The data concern the patients seen by one consultant in 28 such ward rounds during the last four months of 1997, in a teaching hospital where the DME is separate from the department of general internal medicine. 254 patients were seen, 107 men and 147 women, with an average age of 82.4 years (range 73–102). The decisions taken included diagnosis, further investigations, treatment, referral, discharge, and resuscitation status. Very few admissions were judged inappropriate, particularly among the majority referred by general practitioners. 101 patients were thought suitable for transfer to the department of general internal medicine, 109 definitely unsuitable. These findings support the view that, if medical beds are to be freed, the initiative must come from facilitating discharge rather than curtailing admission. Generalists are needed to sort and manage these patients. In the UK, these will often be general internal medicine consultant geriatricians, while the younger patients are seen by consultants practising general internal medicine in addition to one of the specialties. Sizeable numbers of these consultants are needed if the post-take ward round is to be efficient and not conflict with their fixed commitments.

Arterial compliance in older people

2000 ◽  
Vol 10 (1) ◽  
pp. 43-54
Author(s):  
C. Rajkumar ◽  
S. Bonapace ◽  
C. J. Bulpitt
Keyword(s):  
Cardiovascular Diseases ◽  
Elderly Population ◽  
Arterial Compliance ◽  
The Elderly ◽  
Arterial System ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
The Past ◽  
Life Expectancy At Birth ◽  
The Uk

IntroductionLongevity has lengthened in recent times. This has resulted in an increase in the elderly population, with life expectancy at birth in men in the UK being approximately 72.5 years and women, 78.5 years. Despite the risk of death from cardiovascular diseases decreasing in the past 40 years, these still continue to be the largest cause of mortality in the elderly. Cardiovascular mortality and morbidity are lower in women. However, this is not true in the later years of life. After the age of 80, the risk of cardiovascular problems increases to that of men. The cardiovascular changes occurring with aging consists of changes in the heart and arterial system.

Ethics and the law involving the elderly

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Informed Consent ◽  
The Elderly ◽  
Outcome Data ◽  
Ethical Principles ◽  
Assisted Death ◽  
The Uk

The role of ethics in the care of the elderly is discussed, and some of the aspects of importance to anaesthesia are reviewed. Ethical principles are commonly viewed as either consequential, where the risk/benefit balance between necessary harm (surgery) provides improved quality of life, or deontological, where it is simply the action that is judged and not the outcome. The lack of individualized outcome data is identified as a major issue for the consequential process. Consent for surgery (and anaesthesia) is described in the context of the UK, but it is applicable worldwide. The validity of informed consent is reviewed against the criteria of competence, lack of duress, and appropriately provided information. The capacity to give consent and the use of legal alternatives such as health attorneys is detailed. Finally, the debate on excellent palliative care rather than assisted death is reviewed.

scholarly journals The interface between old age psychiatry and the law

2002 ◽  
Vol 8 (4) ◽  
pp. 271-278 ◽  
Author(s):  
Brian Murray ◽  
Robin Jacoby
Keyword(s):  
Old Age ◽  
Psychiatric Care ◽  
Common Law ◽  
Civil Law ◽  
The Elderly ◽  
Legal Aspects ◽  
Northern Irish ◽  
Care For The Elderly ◽  
Old Age Psychiatry ◽  
The Uk

This article aims to provide a practical overview concentrating on civil legal aspects of psychiatric care for the elderly. We limit ourselves to English law (which also has jurisdiction in Wales; Scottish and Northern Irish law may be similar, but not identical). Civil law can, in turn, be divided into statute law (legislation provided by Parliament) and common law (the UK, unlike some European countries, has a strong tradition of law based on previous rulings by judges).

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