Cognitive Changes after Surgery in the Elderly: Does Minimally Invasive Surgery Influence the Incidence of Postoperative Cognitive Changes Compared to Open Colon Surgery?

2014 ◽  
Vol 39 (3-4) ◽  
pp. 125-131 ◽  
Author(s):  
Christopher B. Tan ◽  
Jackson Ng ◽  
Rajkumar Jeganathan ◽  
Fernando Kawai ◽  
Cynthia X. Pan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Laparoscopic Group ◽  
The Elderly ◽  
Colon Surgery ◽  
Open Group ◽  
Elderly Subjects ◽  
Age Difference ◽  
Care Hospital ◽  
Cognitive Changes ◽  
Open Versus

Background: Postoperative delirium in the elderly is a growing concern. Data regarding significant differences in postoperative cognitive dysfunction (POCD) in elderly persons undergoing laparoscopic versus open colon resection are not well established. Objectives: The goal of this study was to compare the incidence of POCD in laparoscopic versus open colon surgery in an elderly population. Design and Setting: A prospective nonrandomized pilot study was conducted at an urban tertiary care hospital. Participants: The study included patients aged 65 years and above, without documented dementia who underwent elective colon surgery. Measurements: We collected demographic and clinical data, including age, sex, polypharmacy, and comorbidities. The subjects underwent pre- and postoperative Cambridge Neuropsychological Test Automated Battery (CANTAB) testing. Worsening individual scores from the Paired Associated Learning (PAL) and Spatial Working Memory (SWM) portions of CANTAB determined the presence of POCD. Inflammatory cytokine (i.e., IL-6) levels were measured pre- and postoperatively. Results: We enrolled 44 subjects (26 laparoscopic and 18 open surgery). The two groups did not differ significantly in age, sex, polypharmacy, and comorbidities. The average incidence of POCD was 47%. PAL scores worsened in 12/23 (52%) in the laparoscopic group and in 7/15 (47%) in the open group. These group differences lacked statistical significance (p = 0.75). SWM scores worsened in 14/25 (56%) in the laparoscopic group and in 6/18 (33%) in the open group, which was also not statistically significant (p = 0.12). No age difference occurred between the ‘worsened scores' group and ‘stable scores' group, and older age was not associated with POCD. IL-6 levels were higher in the open versus the laparoscopic group (p < 0.0001). Conclusion: In this pilot study, the average incidence of POCD was not statistically different between elderly subjects undergoing open versus laparoscopic surgery. Age did not influence the occurrence of POCD. Although inflammatory markers were significantly higher in the open group, consistent with a higher degree of stress response, this group did not have higher rates of delirium. This association is worth to be investigated in a larger sample. © 2014 S. Karger AG, Basel

Age Differences in Performance at Concentration: A Pilot Study

1992 ◽  
Vol 74 (2) ◽  
pp. 412-414 ◽  
Author(s):  
Joyce Chagnon ◽  
Stuart J. McKelvie
Keyword(s):  
Pilot Study ◽  
Age Differences ◽  
Visual Processing ◽  
The Elderly ◽  
Elderly Subjects ◽  
Age Related

24 subjects ranging in age from 5 to 65 years individually played Concentration in pictorial and verbal formats. Consistent with age-related declines in both general and visual processing, performance was poorest for the elderly subjects on both tasks; however, there was no evidence of children's precocity.

scholarly journals Comparison of Laparoscopic VS Open Inguinal Hernioplasty in a Tertiary Care Hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 17-22
Author(s):  
Md Mahfuzul Momen ◽  
Ashok Kumar Sarker ◽  
Deb Prosad Paul ◽  
Debasis Das ◽  
Sonia Akhter ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Laparoscopic Group ◽  
Open Group ◽  
Care Hospital ◽  
Laparoscopic Hernioplasty ◽  
The Mean

Background: Inguinal hernia repair is one of the most common surgical procedures in Bangladesh. The option of surgical treatment remains controversial. Laparoscopic hernia repair has all the benefits of a tension free repair. We aimed to compare postoperative outcome and cost between laparoscopic and open inguinal hernia repair. Objective: This study was conducted with an objective to compare the effectiveness of each procedure and complications if any. Materials and Methods: Fifty cases of inguinal hernia admitted in the tertiary care center were selected by nonprobability (purposive) sampling method. All patients with uncomplicated hernia treated by open or laparoscopic method were included. The age/sex, incidence, mode of presentation, surgical treatment and postoperative complications were evaluated and compared with standard published literature. Results: Postoperative wound infection developed in three cases of open hernioplasty and one case in laparoscopic surgery. Hematoma and seroma at the operated site were found in one case of laparoscopic hernioplasty and in two cases of open hernioplasty. Orchitis was more prevalent in the laparoscopic hernioplasty patient with incidence among two cases as compared to one in open group. The mean duration of hospitalization was 59.62±6.11 hours in case of laparoscopic hernioplasty while 53.33±8.26 hours in open hernioplasty. The mean duration of procedure was 72.33 minutes in laparoscopic group while 64.62 minutes in open surgery. The mean cost for the laparoscopic repair group was around taka 63000/= whereas in the open group it was around 42000/= only with significant difference. Prolonged groin pain was seen in four cases in open group as compared to one in laparoscopically operated cases. Conclusion: There were less post-operative complications in the laparoscopic group. J Enam Med Col 2020; 10(1): 17-22

INVESTIGATION OF PITUITARY-ADRENOCORTICAL FUNCTION IN THE ELDERLY DURING STANDARDIZED OPERATIONS AND POSTOPERATIVE INTRAVENOUS METYRAPONE TEST ASSESSED BY PLASMA CORTISOL, PLASMA COMPOUND S AND EOSINOPHIL CELL DETERMINATIONS

1971 ◽  
Vol 67 (3) ◽  
pp. 495-507 ◽  
Author(s):  
H. Kaalund Jensen ◽  
M. Blichert-Toft
Keyword(s):  
Cell Count ◽  
Plasma Cortisol ◽  
Surgical Stress ◽  
The Elderly ◽  
Adrenocortical Function ◽  
Elderly Subjects ◽  
Postoperative Phase ◽  
Age Difference ◽  
Adrenal System ◽  
Eosinophil Cell

ABSTRACT Twenty elderly subjects with an average age of 73.0 years (range 66–82) underwent standardized surgery (laparotomies). Thirteen younger subjects with an average age of 45.4 years (range 23–58) served as controls. Changes in plasma cortisol, plasma compound S and eosinophil cell count were checked throughout the first 24 hours after surgery. A maximum increase in the plasma cortisol concentration exceeding the spontaneous initial value by 150 and 110 per cent respectively was observed, in the young and elderly subjects. An insignificant rise only was seen in the plasma compound S concentration. The eosinophil cell count fell to less than 50 n/μl. The variations in the three parameters, observed in the geriatric group, indicate a less marked response to surgical stress although no evidence was found for the existence of any significant age difference. Between the fourth and eighth postoperative day, an intravenous metyrapone test was carried out in 13 elderly and 10 young subjects. The changes in the concentration of plasma cortisol and plasma compound S and in the eosinophil cell count were recorded. When exposed to an apparently identical stimulation of the feedback system during the postoperative phase, the elderly patients showed a much greater response than that seen in the younger patients. The possibility that the pituitary-adrenal system in the elderly develops a higher sensitivity following repeated exposures to stress, is discussed. Exhaustion of the pituitary-adrenal system during the postoperative phase was not demonstrated in the elderly.

Comparative Evaluation of Malnutrition Screening in Oncology Patients in an Acute Care Hospital: A Pilot Study

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Sinha Chandni Sen ◽  
LaSalle Colette ◽  
Argabright Debra ◽  
Hollenbeck Clarie B
Keyword(s):  
Pilot Study ◽  
Acute Care ◽  
Comparative Evaluation ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Oncology Patients

scholarly journals Promotion of active ageing through interactive artificial agents in a smart environment

2021 ◽  
Vol 3 (5) ◽  
Author(s):  
Paulo Menezes ◽  
Rui P. Rocha
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
The Elderly ◽  
Training System ◽  
Regular Physical Activity ◽  
List Type ◽  
Multi Agent System ◽  
Agent System ◽  
Multi Agent ◽  
Elderly Users

Abstract Societies in the most developed countries have witnessed a significant ageing of the population in recent decades, which increases the demand for healthcare services and caregivers. The development of technologies to help the elderly, so that they can remain active and independent for a longer time, helps to mitigate the sustainability problem posed in care services. This article follows this new trend, proposing a multi-agent system composed of a smart camera network, centralised planning agent, a virtual coach, and robotic exercise buddy, designed to promote regular physical activity habits among the elderly. The proposed system not only persuades the users to perform exercise routines, but also guides and accompanies them during exercises in order to provide effective training and engagement to the user. The different agents are combined in the system to exploit their complementary features in the quest for an effective and engaging training system. Three variants of the system, involving either a partial set of those agents or the full proposed system, were evaluated and compared through a pilot study conducted with 12 elderly users. The results demonstrate that all variants are able to guide the user in an exercise routine, but the most complete system that includes a robotic exercise buddy was the best scored by the participants. Article Highlights Proposal of a multi-agent system to help elderly adopting regular physical activity habits. A virtual coach and a robotic exercise buddy provide both guidance and companionship during the exercise. A pilot study conducted with 12 elderly users demonstrated an effective and engaging training system.

scholarly journals Extra Virgin Olive Oil Prevents the Age-Related Shifts of the Distribution of HDL Subclasses and Improves Their Functionality

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2235
Author(s):  
Alyann Otrante ◽  
Amal Trigui ◽  
Roua Walha ◽  
Hicham Berrougui ◽  
Tamas Fulop ◽  
...  
Keyword(s):  
Olive Oil ◽  
Virgin Olive Oil ◽  
Density Lipoprotein ◽  
Extra Virgin Olive Oil ◽  
The Elderly ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Elderly Subjects ◽  
Age Related ◽  
Young Subjects

High-density lipoproteins (HDL) maintain cholesterol homeostasis through the role they play in regulating reverse cholesterol transport (RCT), a process by which excess cholesterol is transported back to the liver for elimination. However, RCT can be altered in the presence of cardiovascular risk factors, such as aging, which contributes to the increase in the incidence of cardiovascular diseases (CVD). The present study was aimed at investigating the effect of extra virgin olive oil (EVOO) intake on the cholesterol efflux capacity (CEC) of HDL, and to elucidate on the mechanisms by which EVOO intake improves the anti-atherogenic activity of HDL. A total of 84 healthy women and men were enrolled and were distributed, according to age, into two groups: 27 young (31.81 ± 6.79 years) and 57 elderly (70.72 ± 5.6 years) subjects. The subjects in both groups were given 25 mL/d of extra virgin olive oil (EVOO) for 12 weeks. CEC was measured using J774 macrophages radiolabeled with tritiated cholesterol ((3H) cholesterol). HDL subclass distributions were analyzed using the Quantimetrix Lipoprint® system. The HDL from the elderly subjects exhibited a lower level of CEC, at 11.12% (p < 0.0001), than the HDL from the young subjects. The CEC of the elderly subjects returned to normal levels following 12 weeks of EVOO intake. An analysis of the distribution of HDL subclasses showed that HDL from the elderly subjects were composed of lower levels of large HDL (L-HDL) (p < 0.03) and higher levels of small HDL (S-HDL) (p < 0.002) compared to HDL from the young subjects. A multiple linear regression analysis revealed a positive correlation between CEC and L-HDL levels (r = 0.35 and p < 0.001) as well as an inverse correlation between CEC and S-HDL levels (r = −0.27 and p < 0.01). This correlation remained significant even when several variables, including age, sex, and BMI as well as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glucose levels (β = 0.28, p < 0.002, and β = 0.24, p = 0.01) were accounted for. Consuming EVOO for 12 weeks modulated the age-related difference in the distribution of HDL subclasses by reducing the level of S-HDL and increasing the level of intermediate-HDL/large-HDL (I-HDL/L-HDL) in the elderly subjects. The age-related alteration of the CEC of HDL was due, in part, to an alteration in the distribution of HDL subclasses. A diet enriched in EVOO improved the functionality of HDL through an increase in I-HDL/L-HDL and a decrease in S-HDL.

scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

A Study of Patterns of Dying in a Multilevel Geriatric Setting

1983 ◽  
Vol 2 (2) ◽  
pp. 79-85
Author(s):  
Isabel Brown
Keyword(s):  
Retrospective Study ◽  
Long Term Care ◽  
Death And Dying ◽  
Chronically Ill ◽  
The Elderly ◽  
Care Hospital ◽  
Term Care ◽  
Apartment Complex ◽  
General Community

ABSTRACTA retrospective study was conducted in a large multilevel geriatric centre to analyse the deaths reported in the year 1981. This centre provides accommodation for 750 elderly and/or chronically ill persons in three agencies—an apartment complex, a home for the aged, and a long-term care hospital The study revealed that the hospital is the place of death for a high proportion of the elderly residents of the centre. In particular, residents of the home for the aged are unlikely to remain in the “home” to die. It was found that patterns of death and dying for individuals admitted to the hospital from the general community differ in several ways from the patterns of those who are already living in the centre in terms of age and probable cause of death.

Sensitivity of a modified version of the ‘timed get up and go’ test to predict fall risk in the elderly: A pilot study

2009 ◽  
Vol 49 (1) ◽  
pp. e60-e66 ◽  
Author(s):  
Maria Giné-Garriga ◽  
Míriam Guerra ◽  
Marc Marí-Dell’Olmo ◽  
Carme Martin ◽  
Viswanath B. Unnithan
Keyword(s):  
Pilot Study ◽  
Fall Risk ◽  
The Elderly
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