The Use of Paravertebral Analgesia in the Management of Pain in the Elderly Patient With Rib Fractures

2020 ◽  
pp. 000313482093355
Author(s):  
Tarik Wasfie ◽  
Adam Howell ◽  
N Cwalina ◽  
Raquel Yapchai ◽  
Jennifer Hille ◽  
...  
Keyword(s):  
Elderly Patients ◽  
The Elderly ◽  
Rib Fractures ◽  
Morbidity Rate ◽  
Control Group ◽  
High Morbidity ◽  
Pain Scores ◽  
High Morbidity Rate ◽  
Significant Difference ◽  
The Mean

Background Elderly patients with rib fractures carry a high morbidity rate, particularly due to pulmonary complications as decreased respiratory efforts ensue secondary to pain. Risk of bleeds in the elderly on anticoagulant therapy is high. The effort to reduce narcotic use in patients is now a health care priority. We propose that the use of paravertebral analgesia (PVA) pumps is an alternative pain control method with less risk and easy placement. Methods Two hundred and seventy-nine patients were admitted with multiple fractured ribs to the Trauma Center of Community Hospital and treated with the application of continuous PVA via a pump (72 patients). Pain scores were recorded before and after the initiation of the pump. These patients were compared with a group of the remaining 207 patients who received intravenous narcotics only. Results The mean change from baseline in pain scores for all patients was 1.43 (SD = 2.75). The mean change in pain for the treatment group was 1.93 (SD = 2.60), and the change in pain for the control group was 1.24 (SD = 2.79). Change in pain differed between groups (1.3 vs 1.8; P = .01) although it was a small difference. After adjusting for age, gender, Injury Severity Score, Glasgow Coma Scale, number of fractures, and comorbid conditions, there was no significant difference in pain post-procedure (odds ratio = 0.75; P = 0.39) with an effect size of 30% and total sample size of 279. Conclusion The PVA pump using bupivacaine is an effective safe and alternative method for managing elderly patients with rib fractures eliminating the serious side effects associated with narcotics.

Effectiveness of neurobic exercise program on memory and depression among elderly residing at old age home

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Divya Raj ◽  
Subramaniam Santhi ◽  
G. J. Sara Sapharina
Keyword(s):  
Old Age ◽  
Depression Scale ◽  
Exercise Program ◽  
The Elderly ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
The Mean ◽  
Interventional Group ◽  
Old Age Homes

AbstractObjectivesThis study finds out the effectiveness of neurobic exercise program on memory and depression among elderly residing in old age homes.MethodsThe non-probability purposive sampling technique was used for sample selection. Wechsler's memory scale (WMS-IV) and Geriatric depression scale (GDS) were the instruments used to assess the memory and depression among elderly during the pretest and posttest, respectively and the researcher had developed data sheet to collect information about the background variables using interview technique.ResultsThe neurobic exercise program was found to be effective in reducing depression among elderly residing in old age homes. There was a significant difference (p<0.001) in the level of depression had been found during the pretest and posttest in the interventional group. There was a statistically significant difference (p<0.001) found between the study group and in the control group. There was significant correlation (r=0.417, p<0.05) found between the memory and depression during the pretest in the study group among the elderly. A statistically significant association (p<0.05) found in the mean scores of depression and marital status of the elderly during the pretest in the study group and there was a significant association (p<0.01) found in the mean scores of depression and the gender of the elderly during the pretest and posttest in the non interventional group were found.ConclusionsThe findings suggested that neurobic exercise program is an effective intervention in improving memory and reducing depression.

scholarly journals EFFECT OF BRAIN EXERCISE AND BENSON RELAXATION THERAPY ON DEPRESSION LEVEL IN THE ELDERLY IN THE ELDERLY SOCIAL SERVICE UNIT

2018 ◽  
Vol 4 (2) ◽  
pp. 211-218
Author(s):  
Wulansari Wulansari ◽  
Ani Margawati ◽  
Rita Hadi W
Keyword(s):  
Social Service ◽  
The Elderly ◽  
Mean Value ◽  
Control Group ◽  
Relaxation Therapy ◽  
Service Unit ◽  
Significant Difference ◽  
Depression Level ◽  
The Mean ◽  
And Control

Background: Depression is one of the most common psychosocial problems in the elderly. The incidence of depression in the elderly is greater in the elderly living in the social service unit than the elderly in the community. Management of depression in the elderly should be more emphasized on interventions that focus on the individual needs of the biopsychosocial and spiritual aspects. Brain gym therapy and Benson relaxation are considered appropriate in decreasing depression.Objective: This study was to determine the effect of brain exercise and Benson relaxation on the level of depression in elderly in the elderly social service unit.Methods: This was a quasy experimental study with pretest posttest control group design. Fifty-six elderly included in this study, which 28 assigned in the experiment and control group. The depression level was assessed using Geriatric Depression Scale (GDS). Wilcoxon and Mann-Whitney test were used for data analyses.Results: The study showed that the mean GDS score in the experiment group before the intervention was 7.21, while the mean value of GDS in the control group was 6.64. The mean value of GDS in the experiment group after the intervention was 5.04 and the mean in control group was 6.18. There was a significant difference of GDS score between experiment and control group with p-value of 0.021 (<0.05).Conclusion: There was a significant effect of brain gymnastics and Benson relaxation therapy in reducing depression in elderly. brain gymnastic therapy and benson relaxation can be one of independent nursing interventions as an effort to improve care for elderly groups.

scholarly journals Effect of an aged wearing suit on nursing student’s knowledge and attitude

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zahra Mandegari Bamakan ◽  
Khadijeh Nasiriani ◽  
Farzan Madadizadeh ◽  
Fatemeh Keshmiri
Keyword(s):  
Nursing Students ◽  
The Elderly ◽  
Control Group ◽  
Control Groups ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Knowledge And Attitude ◽  
And Control ◽  
Experimental Group

Abstract Background The knowledge and attitude of health care providers are important and influential factors in providing care services to the elderly and need to be considered during the training course. Simulation in geriatric nursing education can be an opportunity for learners to experience the restrictions of the elderly. The present study was conducted to determine the effect of training through simulation on the attitude and knowledge of nursing students in elderly care. Methods This study was quasi-experimental with two experimental and control groups of pre and post-test, which was conducted on 70 nursing students of the 5th semester (two groups of 35 people). For the experimental group, the elderly simulation suit was worn for two hours, which was designed by the researcher and created sensory, physical, and motor restrictions similar to the elderly for students. Before and after the study, Kogan’s attitudes toward older people scale and Palmore’s “facts on aging quiz” were completed by students. The data were analyzed using an independent t-test and paired t-test using SPSS version 16 software. Results The mean scores of students’ knowledge in the experimental and control groups had no significant difference at the beginning of the study (p < 0.05). But the mean scores of knowledge in the experimental group before and after the intervention was (9.2 ± 2.6) and (15.3 ± 3.5), respectively, and in the control group before and after the intervention was (10.4 ± 2.9) and (11.3 ± 2.6), respectively, which had a statistically significant difference (p = 0.0001). The mean scores of students’ attitudes in the experimental and control groups had no significant difference at the beginning of the study (p < 0.05). The mean scores of attitude in the experimental group before and after the intervention was (114.69 ± 8.4) and (157.31 ± 10.7), respectively and in the control group before and after the intervention was (113.34 ± 13.6) and (108.5 ± 16.6), respectively, which was significantly different (p = 0.0001). Conclusions Based on the findings, the experience of aging restrictions through simulation has improved the knowledge and attitude of nursing students towards the elderly. Nursing education requires the growth of attitudinal skills, individuals’ beliefs, and creating empathy among them, so creating simulation opportunities can assist nursing students in the educational processes.

scholarly journals Level of anxiety caused by the coronavirus (COVID-19) pandemic among dentists in Poland.

2020 ◽  
Author(s):  
Ewa Rusyan ◽  
Agnieszka Mielczarek ◽  
Agnieszka Kapała ◽  
Kamil Adamczyk ◽  
Robert Piec ◽  
...  
Keyword(s):  
Work Experience ◽  
Online Survey ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
High Morbidity Rate

Abstract Background: The early information on both the speed and high morbidity rate and, above all, mortality, triggered the symptoms of COVID-19-related panic and anxiety. Dentists were listed in the top five professions with the highest risk of transmission of the virus. The paper aimed to assess the level of anxiety among dentists in Poland. Methods: A cross-sectional study was conducted via an online survey questionnaire. The study used a tool developed by the team of Ahorsu et al. The COVID-19 Fear Scale (FCV-19S) translated into the Polish language. The online questionnaire was completed by 356 dentists. Results: In the studied population of dentists, the perceived level of anxiety associated with COVID -19 should be considered relatively low. Both gender and work experience had no significant impact on their level. When the respondents had children, lived with the elderly, or looked after them the observed level of anxiety was higher and physical symptoms such as sweating palms and increased heart rate occurred.Conclusion: Despite the high risk of infection, the tested low level of anxiety among dentists is a positive predictor of the appropriate level of medical services provided by this group of doctors.

scholarly journals SPINK7 expression changes accompanied by HER2, P53 and RB1 can be relevant in predicting oral squamous cell carcinoma at a molecular level

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gina Pennacchiotti ◽  
Fabio Valdés-Gutiérrez ◽  
Wilfredo Alejandro González-Arriagada ◽  
Héctor Federico Montes ◽  
Judith Maria Roxana Parra ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Precancerous Lesions ◽  
Morbidity Rate ◽  
Control Group ◽  
High Morbidity ◽  
Less Invasive ◽  
High Morbidity Rate

AbstractThe oral squamous cell carcinoma (OSCC), which has a high morbidity rate, affects patients worldwide. Changes in SPINK7 in precancerous lesions could promote oncogenesis. Our aim was to evaluate SPINK7 as a potential molecular biomarker which predicts OSCC stages, compared to: HER2, TP53, RB1, NFKB and CYP4B1. This study used oral biopsies from three patient groups: dysplasia (n = 33), less invasive (n = 28) and highly invasive OSCC (n = 18). The control group consisted of clinically suspicious cases later to be confirmed as normal mucosa (n = 20). Gene levels of SPINK7, P53, RB, NFKB and CYP4B1 were quantified by qPCR. SPINK7 levels were correlated with a cohort of 330 patients from the TCGA. Also, SPINK7, HER2, TP53, and RB1, were evaluated by immunohistofluorescence. One-way Kruskal–Wallis test and Dunn's post-hoc with a p < 0.05 significance was used to analyze data. In OSCC, the SPINK7 expression had down regulated while P53, RB, NFKB and CYP4B1 had up regulated (p < 0.001). SPINK7 had also diminished in TCGA patients (p = 2.10e-6). In less invasive OSCC, SPINK7 and HER2 proteins had decreased while TP53 and RB1 had increased with respect to the other groups (p < 0.05). The changes of SPINK7 accompanied by HER2, P53 and RB1 can be used to classify the molecular stage of OSCC lesions allowing a diagnosis at molecular and histopathological levels.

P117 THE IMPACT OF ELDERLY ON SURGICAL OUTCOMES AFTER IVOR-LEWIS ESOPHAGECTOMY: REVIEW OF A SINGLE INSTITUTION EXPERIENCE

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
A Cossu ◽  
P Parise ◽  
F Puccetti ◽  
M Palucci ◽  
R Cerchione ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Elderly Patients ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Consecutive Series ◽  
Ivor Lewis ◽  
High Morbidity Rate ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Background Esophagectomy is a surgical procedure burdened by a high morbidity rate. The effect of minimally invasive (MI) approach on elderly patients is still not clear. Aim of this study was to analyze the impact of MI approach on post-operative course according to the patient age. Methods A consecutive series of 692 patients underwent to elective oncological esophagectomy between 1997 and 2017. All data were entered into a prospective database. Patients submitted to 3-flield or trans-hiatal esophagectomy were excluded and only Ivor-Lewis open, hybrid or totally minimally invasive esophagectomy were evaluated. Patients were stratified according to age in 3 groups: Group A (≤ 50 years) 53 patients, Group B (> 51 and < 70 years) 269 and Group C (were ≥71 years) 126. Clinical and pathological factors influencing surgical outcome were evaluated. Complications were classified according to Clavien-Dindo (CD). Results As expected outcomes worsened with patients age (CD ≥ 3b: 7.5% group A, 13% group B and 21% group C. p=0.001), mortality (0% group A, 3% group B and 5.5% group C. p=0.035) and length of stay (10 days group A, 11 days group B and 13 days group C. p=0.001). A statistically significant higher incidence of anastomostic leaks was observed among patients submitted to totally MI esophagectomy in group C vs A and B that were respectively 12,5%, 0% and 7%. Major respiratory complications were not statistically different among these 3 three sub-group. Conclusions Old age has a significant impact on outcomes after esophagectomy. In this subset of patients a MI approach could also increase postoperative morbidity. Elderly patients should be carefully selected before to be submitted to MI esophagectomy.

Effects of Melatonin and Rilmazafone on Nocturia in the Elderly

2007 ◽  
Vol 35 (5) ◽  
pp. 685-691 ◽  
Author(s):  
K Sugaya ◽  
S Nishijima ◽  
M Miyazato ◽  
K Kadekawa ◽  
Y Ogawa
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Sleep Disturbance ◽  
The Elderly ◽  
Treated Group ◽  
Melatonin Level ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

We compared the effects of melatonin, an antioxidant and sleep inducer in humans, and rilmazafone hydrochloride, a hypnotic, in elderly patients with nocturia. Patients received either melatonin (2 mg/day; n = 20) or rilmazafone (2 mg/day; n = 22) for 4 weeks. There were no significant differences in the mean age, the quality of life (QoL) score and the serum melatonin levels between the two groups at baseline. After 4 weeks' treatment, the number of nocturnal urinations was significantly decreased and the QoL score was significantly improved in both groups. There was no significant difference between the patient-reported effectiveness ratings between the two groups. The serum melatonin level was significantly increased in the melatonin-treated group, but it remained unchanged in the rilmazafone-treated group. Melatonin and rilmazafone were equally effective for nocturia in the elderly. We recommend that the problems of sleep disturbance should be considered when choosing a therapy for nocturia.

scholarly journals Virtual reality distraction decreases pain during daily dressing changes following haemorrhoid surgery

2019 ◽  
Vol 47 (9) ◽  
pp. 4380-4388 ◽  
Author(s):  
Jie Ding ◽  
Yanyan He ◽  
Lishan Chen ◽  
Bili Zhu ◽  
Qiuping Cai ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Control Group ◽  
Control Groups ◽  
Open Label ◽  
Pain Scores ◽  
Significant Difference ◽  
The Mean ◽  
Baseline Characteristics ◽  
Dressing Change ◽  
And Control

Objective To investigate whether immersive virtual reality (VR) distraction could decrease pain during postoperative dressing changes. Methods This was a prospective, open-label randomized clinical trial that enrolled patients that had undergone haemorrhoidectomy. Patients were randomly assigned to one of two groups: a control group that received the standard pharmacological analgesic intervention during dressing change and a VR group that received VR distraction during dressing change plus standard pharmacological analgesic intervention. Pain scores and physiological measurements were collected before, during and after the first postoperative dressing change. Results A total of 182 patients were randomly assigned to the control and VR groups. The baseline characteristics of the VR and control groups were comparable. There was no significant difference in mean pain scores prior to and after the dressing change procedure between the two groups. The mean pain scores at the 5-, 10-, 15- and 20-min time-points during the first dressing change were significantly lower in the VR group compared with the control group. Heart rates and oxygen saturation were not significantly different between the two groups. Conclusion Immersive VR was effective as a pain distraction tool in combination with standard pharmacological analgesia during dressing change in patients that had undergone haemorrhoidectomy.

scholarly journals Short-Term Outcomes in Elderly Patients with SARS-CoV-2 Infections Discharged from Community Hospitals

2021 ◽  
Vol 6 (4) ◽  
Keyword(s):  
Elderly Patients ◽  
Community Hospital ◽  
Care Home ◽  
Morbidity Rate ◽  
High Morbidity ◽  
Very Elderly ◽  
Short Term ◽  
Retrospective Case ◽  
High Morbidity Rate ◽  
Hospitalised Patients

Introduction: Clinical outcomes from very elderly hospitalised patients with SARS-COV-2 (Covid-19), are poor, with a reported in-patient mortality as high as 20%. Age, sex, comorbidities, ethnicity and deprivation have all been shown to correlate with worse outcomes in patients with Covid-19, however the outcomes of elderly hospitalised patients once discharged remains unknown. We looked at our cohort of very elderly patients treated within community hospital settings. Methods & Results: A retrospective case note analysis was undertaken within our 222 bedded community hospital structure during the first wave of the pandemic from April to August 2020. A total of 129 patients were treated during this period. The average age of the patients was 78.8 ± 2.7 years. In patient mortality was 11% (14 patients). 83% of patients were discharged from the hospitals. 27% were discharged to care home facilities. At 90 days, 83% of patients were still alive but a third of these patients were re-admitted into hospital with various different diagnoses. Conclusion: Elderly patients who survived Covid-19 infection and left hospital have a relatively high mortality rate in the short-term. Also connected with this is a high morbidity rate and therefore care must be directed within primary care to ensure that this group stay out of hospitals.

scholarly journals PENGARUH SELF-HYPNOSIS TERHADAP INTENSITAS NYERI DAN TINGKAT KECEMASAN LANSIA PENDERITA OSTEOARTRITIS

Biomedika ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 24
Author(s):  
Chandra Irawan ◽  
Aris Sudiyanto ◽  
Mohammad Fanani
Keyword(s):  
Treatment Group ◽  
Pain Intensity ◽  
The Elderly ◽  
Complementary Therapy ◽  
Mean Value ◽  
Control Group ◽  
Intensity Level ◽  
Osteoarthritis Pain ◽  
Significant Difference ◽  
The Mean

Arthritis or rheumatism in the elderly (called osteoarthritis) is chronic and can not be recovered. Pain becomes the main symptoms of osteoarthritis joints experience. The pain can disrupt motor function, sleep disorders and psychological stress. Nowadays, the treatment for elderly with osteoarthritis pain therapy is to pharmacotherapy. Due to psychological disorders such as anxiety and depression play a role in the recurrence of pain, then there is a complementary therapy intervention that is self-hypnosis. Self-hypnosis (as a complementary therapy) popular and familiar because it is easy to do, inexpensive and can be done at home independently. The aimed of this study was to find out whether there is any influence of self-hypnosis on the pain intensity and level of anxiety elderly with osteoarthritis.This study was a quantitative research in the form of quasi experimental randomized pretest-posttest control group design, intervention module using self-hypnosis to reduce pain intensity and level of anxiety elderly with osteoarthritis. This study was approved by the hospital ethics committee. The result of this study was a significant difference in the value pretest and posttest group treated osteoarthritis pain and anxiety elderly. The mean value of NRS (pain) treatment group pretest posttest 1,47 ± 0.57 and 0.97 ± 0.72 with p = 0.001> 0.05. The mean value of TMAS (anxiety) treatment group pretest amounted to 13.13 ± 2.27 posttest 10.93 ± 3.35 with p= 0.000Keywords: Self-Hypnosis, Pain Intensity, Level Of Anxiety, The Elderly With Osteoarthritis.

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