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intubation and elderly

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https://www.readbyqxmd.com/read/28990533/blood-brain-barrier-disruption-leads-to-postoperative-cognitive-dysfunction
#1
Bin Wang, Siyuan Li, Xipeng Cao, Xinghui Dou, Jingzhu Li, Ling Wang, Mingshan Wang, Yanlin Bi
BACKGROUND: Postoperative cognitive dysfunction (POCD) has received considerable attention as one of the main postoperative complications. The underlying mechanism of POCD in elderly subjects has not been fully elucidated to date. The central nervous system (CNS) is isolated from the bloodstream by the blood brain barrier (BBB) that consists of endothelial cells, capillary blood vessels and the tight junctions. The tight junctions carry out significant biological functions that are associated with the CNS and the blood circulation...
October 9, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28890836/new-diagnosis-of-aids-based-on-salmonella-enterica-subsp-i-enterica-enteritidis-a-meningitis-in-a-previously-immunocompetent-adult-in-the-united-states
#2
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28832797/are-the-early-postoperative-outcomes-of-coronary-artery-bypass-grafting-surgery-in-elderly-women-worse-compared-to-men-s
#3
COMPARATIVE STUDY
Ahmet Yüksel, Irem Iris Kan, Atıf Yolgösteren, Yusuf Velioğlu, Mustafa Çagdaş Çayır, Orçun Gürbüz, Gencehan Kumtepe, Serkan Akarsu, Murat Biçer, Mustafa Tok, Işık Şenkaya
Objective: To investigate the impact of gender difference in early postoperative outcomes in elderly patients (aged 70 or older) undergoing coronary artery bypass grafting surgery. Methods: Between October 2009 and December 2013, a total of 223 elderly patients (aged 70 or older) undergoing isolated primary coronary artery bypass grafting surgery were included in this retrospective observational cohort study. Patients were divided into two groups according to their gender...
May 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28816565/dacryocystectomy-as-a-treatment-of-chronic-dacryocystitis-in-the-elderly
#4
Mariana N Meireles, Magda Mh Viveiros, Roberta Lfs Meneghin, Alicia Galindo-Ferreiro, Mariângela Ea Marques, Silvana A Schellini
To evaluate the dacryocystectomy (DCT) outcomes for chronic dacryocystitis in an elderly population over 70 years old. A retrospective chart review was performed for patients over 70 years old who were diagnosed with chronic dacryocystitis and underwent DCT at the Botucatu School of Medicine, UNESP, Brazil, from 2007 to July 2014. Data were collected about patient demographics, age, gender, previous nasal, or ophthalmic diseases, symptoms related to the lacrimal drainage system preoperatively and postoperatively, signs of enlargement of the lacrimal sac (regurgitation of secretion), and histopathologic evaluation...
August 17, 2017: Orbit
https://www.readbyqxmd.com/read/28791477/electroencephalographic-effect-of-age-adjusted-1-mac-desflurane-and-sevoflurane-in-young-middle-aged-and-elderly-patients
#5
Shinya Kanazawa, Yutaka Oda, Chika Maeda, Ryu Okutani
PURPOSE: We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia. METHODS: One hundred and twenty young (20-30 years), middle-aged (31-65 years), and elderly (66-80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation...
October 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28754091/-visually-impaired-elderly-patient-ingests-pill-desiccant-leading-to-acute-hypoxic-respiratory-failure-requiring-intubation
#6
Wendy Gerstein, Ziyang Liu
BACKGROUND: A significant percentage of elderly patients suffer from both polypharmacy and visual impairment. This combination can increase the risk of an adverse event related to medication. This case highlights an unusual, but potentially deadly, medication adverse event. CASE PRESENTATION: A 77-year-old male, visually impaired, ingested a pill desiccant, believing it was the ampicillin/sulbactam tablet he was prescribed for an infected diabetic foot ulcer. He presented to the emergency room with inability to swallow, and imaging revealed the pill desiccant lodged in his upper esophagus...
July 28, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28743341/-effect-of-external-abdominal-aorta-compression-on-circulation-during-anesthesia-induction-in-elderly-patients
#7
Xiuman Li, Lixiang Wang
OBJECTIVE: To investigate the effect of external abdominal aorta compression on circulation during anesthetic induction in elderly patients. METHODS: A prospective randomized controlled trial was conducted. Patients with age of 60-75 years old, requiring a general anesthesia for non-abdominal surgery, and with II-III class of American Society of Anesthesiologists (ASA) physical status classification, and admitted to General Hospital of Chinese People's Armed Police Forces from January to April in 2017 were enrolled...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28736324/survival-and-neurological-outcome-in-the-elderly-after-in-hospital-cardiac-arrest
#8
G Hirlekar, T Karlsson, S Aune, A Ravn-Fischer, P Albertsson, J Herlitz, B Libungan
BACKGROUND: There have been few studies of the outcome in elderly patients who have suffered in-hospital cardiac arrest (IHCA) and the association between cardiac arrest characteristics and survival. AIM: The aim of this large observational study was to investigate the survival and neurological outcome in the elderly after IHCA, and to identify which factors were associated with survival. METHODS: We investigated elderly IHCA patients (≥70years of age) who were registered in the Swedish Cardiopulmonary Resuscitation Registry 2007-2015...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28653101/ct-guided-cement-sacroplasty-csp-as-pain-therapy-in-non-dislocated-insufficiency-fractures
#9
Reimer Andresen, Sebastian Radmer, Mathias Wollny, Julian Ramin Andresen, Urs Nissen, Hans-Christof Schober
INTRODUCTION: In elderly patients with reduced bone quality, insufficiency fractures of the sacrum are relatively common and are typically associated with severe disabling pain. The objective of the present study was to examine the feasibility of cement augmentation by CSP, to determine post-interventional leakages and other complications, and to present the outcome of pain over the course of 18 months. MATERIALS AND METHODS: In 23 patients (20 women and 3 men) with an average age of 81...
June 26, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#10
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28507892/a-case-of-massive-hemoptysis-following-transesophageal-echocardiogram
#11
Sean J Callahan, Robert M Jones, Dana Albon, Andrew D Mihalek
INTRODUCTION: Tracheal intubation leading to injury of the airway is a rare complication of transesophageal echocardiography (TEE). Tracheal trauma is not a described complication of TEE, and safety literature for this procedure remains silent on the matter. We describe the case of a patient on systemic anticoagulation and antiplatelet therapy who underwent TEE and suffered massive hemoptysis requiring bronchial artery embolization (BAE). CASE PRESENTATION: An elderly patient was admitted to the hospital with recently diagnosed atrial fibrillation and shortness of breath...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#12
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28489775/effects-of-nimodipine-on-postoperative-delirium-in-elderly-under-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#13
Ya-Nan Li, Qi Zhang, Chun-Ping Yin, Yang-Yang Guo, Shu-Ping Huo, Liang Wang, Qiu-Jun Wang
Nimodipine is a clinical commonly used calcium antagonistscan lowering the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). This study was designed to evaluate the effects of nimodipine on postoperative delirium in elderly under general anesthesia.Sixty patients shceduced spine surgery under general anesthesia were randomly assigned into 2 groups using a random number table: control group (Group C) and nimodipine group (Group N). In Group N, nimodipine 7...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28467584/the-geriatric-polytrauma-risk-profile-and-prognostic-factors
#14
Holger Rupprecht, Hans Jürgen Heppner, Kristina Wohlfart, Alp Türkoglu
BACKGROUND: In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. METHODS: Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS)...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#15
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28445418/hyponatremia-is-associated-with-worse-outcomes-from-fall-injuries-in-the-elderly
#16
Spencer C H Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu, Ching-Hua Hsieh
Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods: We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included...
April 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28386747/hospital-cost-savings-and-other-advantages-of-sutureless-vs-stented-aortic-valves-for-intermediate-risk-elderly-patients
#17
Tomoyuki Minami, Sarah Sainte, Herbert De Praetere, Filip Rega, Willem Flameng, Peter Verbrugghe, Bart Meuris
PURPOSE: To evaluate and compare the clinical outcomes and hospital costs of using sutureless aortic valves vs conventional stented aortic valves. METHODS: Between 2007 and 2011, 52 elderly patients undergoing aortic valve replacement for aortic stenosis in our center had a sutureless valve inserted. From among 180 patients who had a stented valve inserted during the same period, 52 patients were matched to the sutureless group, based on age, gender, and operation type...
April 6, 2017: Surgery Today
https://www.readbyqxmd.com/read/28366293/procedural-difficulties-during-successful-intubation-in-octogenarians-a-prospective-observational-study
#18
Y F Bryan, K N Johnson
OBJECTIVE: Octogenarians undergo anatomic and physiopathologic degradation, making airway management problematic, specific to intubation, bag mask ventilation, leading to desaturation and aspiration. Our study's aim was to examine the process of airway management regarding the steps involved in intubation and any deviations or delays in the tasks. MATERIALS AND METHODS: An institutional review board-approved difficult airway prospective observational study in older adults was conducted...
March 30, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28362659/neuroleptic-malignant-syndrome-secondary-to-metoclopramide-use-in-an-elderly-gastroenterologic-surgery-patient
#19
Richard Breeden, Heath Ford, Carey Chrisman, Charles Mascioli
An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed...
March 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28286198/in-hospital-mortality-and-post-transplantation-complications-in-elderly-multiple-myeloma-patients-undergoing-autologous-hematopoietic-stem-cell-transplantation-a-population-based-study
#20
Larysa Sanchez, Michael Sylvester, Ricardo Parrondo, Veronica Mariotti, Jean Anderson Eloy, Victor T Chang
Autologous hematopoietic stem cell transplantation (auto-HSCT) has improved survival in patients with multiple myeloma (MM) and is increasingly used in elderly patients. The aim of this study was to characterize and compare in-hospital complications and mortality after auto-HSCT in younger (< age 65) versus elderly (> age 65) MM patients utilizing the Nationwide Inpatient Sample. Over a 3-year period (2008 to 2010), 2209 patients with MM were admitted to US hospitals for auto-HSCT. The median age was 59 years, with 1650 patients (74...
March 9, 2017: Biology of Blood and Marrow Transplantation
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