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Pain and treatment and elderly

Timo Nyyssönen, Iikka Lantto, Peter Lüthje, Tuomas Selander, Heikki Kröger
The incidence of Achilles tendon (AT) rupture, especially non-sport related rupture, is increasing, while the reasons for this increase are largely unknown. The association between AT rupture and the use of various drug treatments was studied. We collected AT rupture patients from the Finnish Hospital Discharge Register. We also acquired information about all the doctor-prescribed drugs they had purchased within one year before the rupture. For comparison, we randomly selected age- and sex-matched controls from the Finnish Population Register...
August 18, 2018: Scandinavian Journal of Medicine & Science in Sports
Samuel N Grief, Julie K Loza
Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia...
September 2018: Primary Care
Haiwei Shi, Long Xiao, Zhifang Wang
Curative effect of artificial femoral head replacement on hip joint function and complications of elderly patients with femoral intertrochanteric fracture were investigated. Eighty patients who were operated for femoral intertrochanteric fractures operation were randomly divided into observation group (n=40) and control group (n=40). The observation group was treated with artificial femoral head replacement, while the control group received internal proximal femur locking plate fixation. In the observation group, the operation time was shorter than that in the control group (P<0...
August 2018: Experimental and Therapeutic Medicine
Carlos Salazar, Nelson Kanter Md, Amer Abboud
Malignant pleural mesothelioma (MPM) is a rare neoplasm. It predominantly affects elderly individuals aged over 70 years presenting with a unilateral pleural tumor usually associated with previous asbestos exposure. The respiratory symptoms are associated with ipsilateral pleural involvement with concomitant pleural effusions. The diagnosis of MPM is established by the morphologic and immunohistochemical features of a cytologic specimen. MPM can present as three histologic subtypes: epithelioid, sarcomatoid, or biphasic...
June 6, 2018: Curēus
Amir Awwad, Renan E Ibrahem Adam, Chandni Patel, James D Thomas
Introduction: Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing's syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Surgical decompression is known to improve symptomatic cases and prevent further deterioration. Case presentation: An elderly male patient with background history of high-risk metastatic prostate cancer and long-term treatment with steroids and hormonal therapy presented with acute on chronic back pain and neurological symptoms...
2018: Spinal Cord Series and Cases
Karolina Piotrowicz, Krzysztof Rewiuk, Stanisław Górski, Weronika Kałwak, Barbara Wizner, Agnieszka Pac, Michał Nowakowski, Tomasz Grodzicki
BACKGROUND: In hospital settings, delirium affects as many as 50% of older patients, aggravating their symptoms and worsening their condition, and therefore increasing the risk of in-hospital complications and death. The aim of this study is to assess the efficacy of structured, non-pharmacological care, delivered to older hospitalised patients by trained volunteers (students of medical fields), on the reduction of incidence of adverse health-related outcomes. METHODS/DESIGN: This trial will be a randomised, investigator-blind, controlled trial conducted in an internal medicine and geriatric ward in Poland...
August 14, 2018: Trials
Jian Wang, Xiang Wang, Yun Cao, Tao Huang, Deng-Xin Song, Hai-Rong Tao
Knee osteoarthritis (OA) is the main cause of leg pain in middle‑aged and elderly individuals. Hyaluronic acid (HA), as well as curcuminoid, has been used in the treatment of knee OA. In the present study, HA/chitosan nanoparticles (CNPs) were prepared for the delivery of curcuminoid, in order to investigate whether HA and curcuminoid can act synergistically as a better treatment option. The knee OA model was established by the Hulth method, and a knee OA chondrocyte model was constructed by the co‑induction of interleukin‑1β and tumor necrosis factor (TNF)‑α...
August 9, 2018: International Journal of Molecular Medicine
Huong Thi Thu Nguyen, Mackenzie Pi Moir, Thanh Xuan Nguyen, Anh Phuong Vu, Long Hoang Luong, Tam Ngoc Nguyen, Long Hoang Nguyen, Bach Xuan Tran, Tung Thanh Tran, Carl A Latkin, Melvyn Wb Zhang, Roger Cm Ho, Huyen Thanh Thi Vu
Background: Health-related quality of life (HRQoL) is an important indicator for designing care and treatment services for patients with diabetes. This is especially true given its rapid increase among the elderly population in Vietnam. HRQoL data in elderly diabetic Vietnamese are currently limited. This study aimed to 1) measure the HRQoL of elderly patients with type 2 diabetes (T2DM) in Vietnam and 2) identify related factors and their relationship with HRQoL. Patients and methods: A cross-sectional study was conducted...
2018: Patient Preference and Adherence
Fabiola Aguilera, Tajudeen O Dabiri, Daniel T Farkas
Perforation of the gastrointestinal tract may present with abdominal pain and imaging demonstrating pneumoperitoneum. These findings usually require exploratory laparotomy for diagnosis and treatment. Tubo-ovarian abscess (TOA) is a complication of pelvic inflammatory disease presenting as an encapsulated inflammatory mass, but it can occasionally involve other pelvic organs. TOA is most commonly seen in females of reproductive age. Here we report a case of a 63-year-old female presenting with abdominal pain, fever and vomiting...
August 2018: Journal of Surgical Case Reports
Salman Khalid, Young Jin Youn, Michael Azrin, Juyong Lee
May-Thurner syndrome (MTS) refers to venous outflow obstruction caused by extrinsic compression of the left common iliac vein (LCIV) by the overlying pulsatile right common iliac artery against lumbar vertebrae. The classic clinical presentation is acute unilateral left leg painful swelling due to deep venous thrombosis in a young woman in the second or third decade of life. We present a case of a 66-year-old woman who presented with late-onset left leg swelling caused by nonthrombotic venous hypertension due to degenerative lumbar disc bulge leading to LCIV compression against the left common iliac artery which was confirmed by computed tomography and intravascular ultrasound...
August 9, 2018: Vascular and Endovascular Surgery
Ruth Prieto, Xavier Santander, José Manuel Naranjo, Esperanza Marín, Cesáreo Corbacho
BACKGROUND: Dumbbell-shaped schwannomas involving the spinal canal, the intervertebral foramen and the thoracic cavity are rare lesions. Their surgical treatment represents a challenge and there is no consensus regarding their ideal management. Two major surgical routes have been used: a combined laminectomy and open thoracotomy, or a posterolateral extrapleural approach with wide bone removal. This report describes a relatively easy surgical strategy, the combined laminectomy and thoracoscopy, which allows a safe resection under an adequate view with low risk of spinal instability, pain or respiratory problems...
August 6, 2018: World Neurosurgery
Shinji Takahashi, Masatoshi Hoshino, Hiroyuki Yasuda, Hidetomi Terai, Kazunori Hayashi, Tadao Tsujio, Hiroshi Kono, Akinobu Suzuki, Koji Tamai, Shoichiro Ohyama, Hiromitsu Toyoda, Sho Dohzono, Fumiaki Kanematsu, Yusuke Hori, Hiroaki Nakamura
STUDY DESIGN: Propensity score matching study OBJECTIVE.: To assess the cost effectiveness of balloon kyphoplasty (BKP) in Japan. SUMMARY OF BACKGROUND DATA: Osteoporotic vertebral fracture (OVF) is a common disease in elderly people. In Japan, the incidence of painful OVF in 2008 was estimated as 880,000, and approximately 40% of patients with painful OVF are hospitalized due to the severity of pain. Japan is the front runner among super-aged societies and rising health care costs are an economic problem...
August 6, 2018: Spine
Yuichi Sumii, Kazuhiko Yamamoto, Yasushi Omura, Wakako Oda, Eisei Kondo, Tadashi Oyama, Chihiro Kamoi, Yutaro Shiraishi, Yoshikazu Yamamoto, Daigo Niiya, Yasuhiro Shiote, Kenji Imajo
A 73-year-old male with melena was admitted to our hospital. Computed tomography (CT) scan revealed the thickening of the jejunal and ileal walls and swelling of the mesenteric lymph nodes. Type II enteropathy-associated T-cell lymphoma (EATL) was diagnosed based on the pathological analysis of the resected specimen. Positron emission tomography and CT scan showed complete remission (CR) after surgery, and he further received CHOP therapy. However, 2 months after the completion of the therapy, the patient's disease relapsed, and he presented with abdominal pain...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Vinod Dasa, Sooyeol Lim, Peter Heeckt
Osteoarthritis (OA) of the knee is a top cause of disability among the elderly. Total knee replacement (TKR) has been available as an effective and definite surgical method to treat severe OA of the knee. However, TKR is a significant procedure with potential risk for serious complications and high costs. Alternative lower risk therapies that can delay or obviate TKR are valuable to those who are poor candidates for surgery or wish to avoid TKR as long as possible. Given the chondroprotective effects of hyaluronic acid (HA) injections, they are a safe and effective treatment to improve pain, function, and longevity of the knee...
July 2018: American Journal of Orthopedics
Huei-Wen Lim, Benny Yiu Wong, David Elkowitz, Keith Sultan
An 85-year-old woman presented with 9.1 kg (20 lb) weight loss over 5 months and an acute onset crampy abdominal pain. Examination revealed a diffusely tender abdomen, with gastric wall thickening noted on CT scan. Upper endoscopy showed diffuse severe erythema and friability. Histologic examination with hematoxylin and eosin staining revealed collagenous gastritis characterized by active chronic inflammation with sub-epithelial collagen deposition and erosion. The patient was started on steroid therapy with rapid clinical improvement and tapered off over 2...
August 2018: Therapeutic Advances in Chronic Disease
Michael Kehrer, Sebastian Koob, Andreas Kehrer, Dieter Christian Wirtz, Jan Schmolders
BACKGROUND: Multiple myeloma is a haematological blood cancer in elderly patients, in which neoplastic cell populations cause osteolytic destruction in the bone skeleton. More than 50% of all patients sustain pathological fractures during the course of their disease. Of all malignant lesions of the spine, multiple myeloma is the most frequent spinal tumour and accounts for approximately 15% of all cases. 8 - 10% of the patients develop neurological deficits. In addition to systemic antineoplastic therapy, surgical treatment is often required in order to reconstruct and stabilise bone defects associated with multiple myeloma, as well as to address tumour-related complications...
July 31, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Lim Soo May, Zulkefli Sanip, Amran Ahmed Shokri, Azidah Abdul Kadir, Md Rizman Md Lazin
BACKGROUND: Osteoarthritis is a common problem affecting the joints in the elderly, caused disability and consequently decrease the quality of life. The conservative treatment includes the usage of analgesia, but the use of herbal medicine is growing. Momordica charantia or bitter melon has been widely described to have anti-diabetic and anti-inflammatory effects. However, its effect on reducing pain in primary knee osteoarthritis is not well studied. We aim to determine the effects of Momordica charantia in reducing pain among primary knee osteoarthritis patients...
August 2018: Complementary Therapies in Clinical Practice
Sybil Skinner-Robertson, Mohamad-Samer Mouksassi, France Varin
BACKGROUND: Understanding analgesic pharmacodynamics (PD) in the elderly is key to optimising pain management. Electrically stimulated pain models (ESPM) permit assessment of pain responses in humans. C and A-delta sensory fibres convey pain and respond to low frequency electrical stimulus (5 and 250 Hz, respectively). Human research suggests pain tolerance threshold (PTT) is similar or decreases with age. OBJECTIVES: To determine whether an ESPM is able to detect a difference in PTT in elderly (>/= 75 years) and young (20-40 years) subjects after single dose administration of a placebo and tramadol, a low potency analgesic...
July 2018: Pain Physician
Xiaoqing Chen, Rongqing Qin, Jie Hao, Cheng Chen, Baiyu Qian, Kai Yang, Feng Zhang
PURPOSE: We aimed to investigate the surgical strategy, safety, and efficacy of percutaneous endoscopic decompression via transforaminal approach for lumbar lateral recess stenosis in geriatric patients. METHODS: From January 2012 to June 2014, 25 elderly patients (18 males and 7 females) with symptomatic lumbar lateral recess stenosis were performed percutaneous endoscopic transforaminal decompression. The ages of patients ranged from 70 to 93 years (mean 79.6 years)...
July 19, 2018: International Orthopaedics
Kağan Özkuk, Bilal Uysal, Zeynep Ateş, Burcu Metin Ökmen, Refia Sezer, Gamze Dilek
This study aimed to investigate the effect of inpatient vs outpatient spa therapy on pain, quality of life, and anxiety in elderly patients with generalized osteoarthritis. A total of 150 patients were randomized into three groups. Group I was given medical treatment, group II was treated as outpatients, and group III was treated as inpatient spa therapy. Assessments were made using the Pain (VAS), EQ-5D-3L Scale, and State and Trait Anxiety Inventory (STAI) at the beginning of treatment (W0), at the end of treatment (W2), and at the fourth week after treatment (W6)...
July 18, 2018: International Journal of Biometeorology
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