• Title/Summary/Keyword: Older patients

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Comparison of the Presence of Multiple Chronic Diseases Older Adults Transferred from Long-term Care Hospitals to Emergency Departments (요양병원에서 응급실로 전입된 노인의 복합만성질환 유무 비교)

  • Huh, Young-Jin;Kim, Ji-Yeon;Lee, Myoung-Hwa;Oh, Mi-Ra
    • Journal of Convergence for Information Technology
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    • v.11 no.6
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    • pp.154-161
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    • 2021
  • This study analyzed the characteristics of the presence of multiple chronic diseases (MCDs) in older adults who transferred from long-term care hospitals (LTCHs) to emergency departments (EDs). According to the data from the national emergency department information system from January 1, to December 31, 2019, the number of older adults transferred from LTCHs to the ED due to chronic diseases was 13,608. Among those who MCDs, 79.9% were over 75 years old, and 74.0% were hospitalized for MCDs. The length of stay in the ED differed according to the presence of MCDs (P<0.001). As for the prevalence of MCDs, the odds ratio (OR) of the ED and in the hospitalized patients was high in Gwangju (OR 8.899 vs. 8.142) and Jeonbuk (OR 13.865 vs. 10.676). As described above, the characteristics of patients regarding the presence of MCDs varied according to age and region.

Head and Neck Squamous Cell Carcinoma - Comparative Evaluation of Pathological Parameters in Young and Old Patients

  • Naz, Samreen;Salah, Kanwal;Khurshid, Amna;Hashmi, Atif Ali;Faridi, Naveen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4061-4063
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    • 2015
  • Background: To evaluate pathological features of head and neck squamous cell carcinoma (HNSCC) and to compare these pathological features in patients younger and older than 40 years. Materials and Methods: All resection specimens of HNSCC between 2010 and 2013 evaluated. Tumor characteristics - grade, location (site) cervical node status, alongwith presence or absence of extranodal extension, lymphovascular invasion, gender and age - were extracted from surgical pathology reports. Results: Among these n=19 patients (21.8%) were 40 years or younger and n=68 patients (78.2%) were above 40 years of age. The mean age was 34 (20-40 years) in the younger group and 56 (42-86) in the older group. The most common location of HNSCC in both groups was the oral cavity. The analysis of histopathological features including grade of tumor, tumor size, extranodal extension and comparison between two groups do not show any significant difference. Conclusions: There are no specific pathological characteristics of HNSCC in young patients. An interesting observation is that exposure to expected risk factors is similar in both groups, in younger patients they have less time to act and yet tumors are the same in terms of tumor size, lymph node status and lymphovascular invasion. Therefore further research is recommended to look for potentiating factors.

Oral Antihyperglycemic Medication Adherence and Its Associated Factors among Ambulatory Care with Adult Type 2 Diabetes Patients in Korea (우리나라 성인 2형 당뇨환자에서의 외래 투약 순응도와 관련요인 분석)

  • Hong, Jae-Seok;Kang, Hee-Chung
    • Health Policy and Management
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    • v.20 no.2
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    • pp.128-143
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    • 2010
  • Objectives : This study aims to estimate the oral antihyperglycemic medications adherence among ambulatory care with adult type 2 diabetes patients and to identify factors affecting the medication adherence in Korea. Methods : This study used the Korean National Health Insurance Database. Study population was 40,082 patients who were 20 years of age or older and first diagnosed with type 2 diabetes (ICD-10: E11) in 2004. The patients were followed up for two years in order to measure adherence with oral antihyperglycemic medications. The level of medication adherence was measured by the medication possession ratio (MPR). Results : The average MPR in the study population was 49.5%. The appropriate adherence rate (MPR$\geq$80%) was 29.4% and showed variation according to the characteristics of individual patients. Multiple logistic regression analysis revealed that the odds of appropriate adherence increased with female (OR:1.21, CI:1.14-1.27), older age, increasing ambulatory care visits, health insurance (OR:1.53, CI:1.33-1.76), decreasing ambulatory care providers, using a specialized general hospital as their main attending medical institution (OR:10.08, CI:8.96-11.33), having co-morbidity, using polytherapy (OR:1.07, CI:1.01-1.13). Conclusions : The medications adherence for patient with type 2 diabetes is low in Korea, and shows variation according to the characteristics of patients. For proper management of diabetes, health care policy is expected to be enacted to improve medications adherence continuously. In particular, more intensive management is needed for patients with low medications adherence. Also, health care policy makers need to develop the program to induce health care utilization by a patient to be more concentrated with the same provider.

Relationship of tooth mortality and implant treatment in Type 2 diabetes mellitus patients in Korean adults

  • Jung, Hyun-Yub;Kim, Yong-Gun;Jin, Myoung-Uk;Cho, Jin-Hyun;Lee, Jae-Mok
    • The Journal of Advanced Prosthodontics
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    • v.5 no.1
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    • pp.51-57
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    • 2013
  • PURPOSE. The purpose of this study was to to analyze the effect of Type 2 diabetes on tooth mortality, implant treatment and prosthetic status. MATERIALS AND METHODS. 275 Type 2 diabetics and 300 non-diabetics, aged 40-80 years were selected for analysis. The assessment of number of teeth, missing teeth, fixed prostheses (bridge pontics), implants using panoramic radiographs and dental records were carried out. RESULTS. Diabetes mellitus (DM) patients had a higher number of missing teeth (P<.05) and placed implants (P=.074), age (P<.05), male gender percentage (P=.042), smoker percentage (P<.05) than non-DM patients. In univariate analysis, the patients in older group showed significantly higher number of tooth loss rate at the first dental examination than the patients in younger group. Tooth loss rate of smokers did not show higher value than that of non-smokers. When multiple variables including DM, age, smoking, gender were considered together, diabetics and older group patients showed significantly higher tooth loss rate at the first dental examination than non-diabetics and younger group patients, respectively. Smokers and male group did not show a significant difference than nonsmokers and female group, respectively. CONCLUSION. Tooth mortality and implant treatment rate were significantly higher in the DM group as indicated by univariate and multivariate logistic regression analysis. Old age groups showed significantly higher odds ratios and tooth loss rate. As diabetics showed the higher tooth loss rate than non-diabetics, diabetics also had more implant restorations than non-diabetics.

Epidemiology of violence in pediatric and adolescent nasal fracture compared with adult nasal fracture: An 8-year study

  • Yu, Hahyun;Jeon, Minseok;Kim, Youngjun;Choi, Youngwoong
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.228-232
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    • 2019
  • Background: The epidemiology of nasal fractures varies according to factors such as the era and area of the study, as well as the age of the patient. We compared the characteristics and causes of pediatric nasal fractures. Methods: A total of 2,321 patients with nasal fractures from 2010 to 2017 were examined. The patients were divided into age groups using the Korean school system of age classification. The causes of injury were divided into five groups: violence, fall or slip down, sports, road traffic accidents, and others. Fractures were classified using the Stranc and Robertson standard: vector of force and plane of fracture. Results: Violence was the most common cause of nasal fracture in patients older than 12 years. Violence was a significantly less frequent cause among patients younger than 12 years old than among adolescent and adult patients. Nasal fractures due to violence were not observed in patients younger than 10 years. Plane 2 and lateral force fractures were the most common; however, in patients younger than 12 years, frontal force fractures were significantly more frequent than were lateral force fractures. Conclusion: As children may simply be injured due to a fall or slip down, it is important for the parents and guardians to ensure their safety. As they become older, children should abstain from violence and be monitored. It is therefore very important to ensure that the environment is free of violence in order to prevent such injuries.

Magnetic resonance imaging analysis of screw in-type lateral anchor pull-out in large to massive rotator cuff repair in patients older than 60 years

  • Lee, Sang-Yoon;Noh, Young-Min
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.15-21
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    • 2022
  • Background: This study was performed to identify the incidence of screw in-type lateral anchor pull-out in patients older than 60 years who underwent rotator cuff repair for large to massive rotator cuff tear (RCT). Methods: We reviewed 25 patients over 60 who were diagnosed with large to massive RCT and underwent arthroscopic rotator cuff repair in our hospital from March 2017 to February 2021. Preoperative tear size (anterior to posterior, medial to lateral) was measured via preoperative magnetic resonance imaging (MRI). All 25 patients underwent MRI scanning on postoperative day 1 and at 3 months after surgery. The change of anchor position was measured in axial views on MRI images postoperative day 1 and 3 months after surgery. And it was statistically compared according to bone mineral density (BMD), sex, and number of lateral anchors. Results: Two MRIs (postoperative day 1 and 3 months) in 25 patients were compared. Anchor pull-out occurred in six patients during 3 months (6.7%), and the mean pull-out length difference was 1.56 mm (range, 0.16-2.58 mm). There was no significant difference in the number of pull-out anchors, degree of pull-out difference by comparing BMD (A, BMD≤-2.5; B, BMD>-2.5), sex, or number of anchors used in each surgery (C, two anchors; D, three anchors) (p>0.05). Conclusions: Pull-out of screw in-type anchors was rarely observed and the mean pull-out length difference was negligibly small in our study. The screw in-type lateral anchor seems to be a decent option without concern of anchor pull-out even in elderly patients.

Effects of Self-management Program applying Dongsasub Training on Self-efficacy, Self-esteem, Self-management Behavior and Blood Pressure in Older Adults with Hypertension (동사섭 훈련 적용 자기관리프로그램이 고혈압 노인의 자기효능감, 자아존중감, 자기관리행위 및 혈압에 미치는 효과)

  • Kim, Myoungsuk;Song, Misoon
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.576-586
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    • 2015
  • Purpose: The purpose of this study was to develop a self-management program applying Dongsasub training based on self-efficacy theory, and to verify the program effectiveness on self-esteem as well as self-efficacy, self-management behaviors, and blood pressure. Methods: The study design was a non-equivalent, pre-post controlled quasi-experiment study. Thirty-eight patients aged 65 and older from a senior welfare center in Seoul participated in this study (20 patients in the experimental group and 18 patients in the control group). The self-management program applying Dongsasub training consisted of eight sessions. After development was complete the program was used with the experimental group. Outcome variables included self-efficacy, self-esteem, self-management behaviors measured by questionnaires, and blood pressure measured by electronic manometer. Results: Self-efficacy (t=2.42, p=.021), self-esteem (t=2.57, p=.014) and self-management behaviors (t=2.21, p=.034) were significantly higher and systolic blood pressure (t=-2.14, p=.040) was significantly lower in the experimental group compared to the control group. However, diastolic blood pressure (t=-.85, p=.400) was not significantly different between the two groups. Conclusion: The results indicate that the self-management program applying Dongsasub training can be used as a nursing intervention in community settings for improving self-management behaviors for older adults with hypertension.

The Effects of Therapeutic Exercise on the Balance and Gait in Older Adults (치료적 운동이 노인의 균형과 보행에 미치는 효과)

  • Lee, Soo-Yeon;Son, Gil-Soo;Jeon, Hye-Jin;Lee, Moon-Hwan
    • The Journal of Korean Physical Therapy
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    • v.19 no.2
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    • pp.1-10
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    • 2007
  • Purpose: This study was conducted to investigate whether therapeutic exercise has effectiveness on the balance and gait in older adults. Methods: 30 patients were participated in this study. To evaluate the effects of therapeutic exercise, patients were evaluated by using One leg stand test which was static balance test, Berge balance test, Functional reach test and Get up and go test which was dynamic balance test. Finally Gait pattern were assessed by using 3-dimensional gait analysis system. The assessment parameters were evaluated before and after treatment. And we received a consent form from all patients. The data were analyzed by paired t-test for compare pre and after therapeutic exercise. Results: One leg stand test was significantly increased after than before therapeutic exercise. Get Up and Go test was significantly decreased after than before therapeutic exercise. Functional Reach test was significantly increased after than before therapeutic exercise. Burge Balance test was significantly increased after than before therapeutic exercise. Stride length was significantly increased after than before therapeutic exercise. Cadence was significantly increased after than before therapeutic exercise. Velocity was significantly increased after than before therapeutic exercise. Conclusion: We thought that therapeutic exercise that is mat exercise has effectiveness on the balance and gait in older adults.

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Comparison of open reduction and internal fixation with total elbow arthroplasty for intra-articular distal humeral fractures in older age: a retrospective study

  • Baik, Jong Seok;Lee, Sung Hyun;Kang, Hyun Tak;Song, Tae Hyun;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.94-99
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    • 2020
  • Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

The Effect of Aqua Exercise on Female Patients with Knee Degenerative Arthritis (수중운동이 무릎퇴행성관절염 여성 환자에 미치는 영향)

  • Park, Jin-Sik;Yoo, Wang-Keun;Jung, Hyun-Suk;Han, Jong-Man;Yang, Kyung-Han
    • Journal of Society of Preventive Korean Medicine
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    • v.12 no.3
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    • pp.129-139
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    • 2008
  • The purpose of this study was to investigate the effect of aqua exercise on women 50 years of age or older with knee degenerative arthritis, and then examining the therapeutic value of aqua exercise in degenerative arthritis of the knee. The subjects of the study were 115 residents 50 years of age or older who had been diagnosed as degenerative arthritis of the knee by doctors from medical institutions and applied for the aqua exercise program in the Public Health Care Center in Suseong-gu in 2006 and 2007. Experiments were conducted to all the subjects with the application of the 8-week aqua exercise program (2 times a week, 50 minutes a time), designed in the study, and the differences before and after the aqua exercise were compared through questionnaires for measuring the state of the body such as the knee extension angles, weight, body fat, and abdominal obesity. The data was analyzed by t-test and the Wilcoxon method through SPSS 14.0 and the statistical significance level ${\alpha}$ was set at 0.05 and 0.01. The results of the study are as the following. First, In comparison of before and after the aqua exercise, there was improvement in the extension angle of the right knee(p<0.01), while there was some improvement in the extension angle of the left knee, it was not significant. Second, In comparison of before and after the aqua exercise there were statistically significant differences in weight(p<0.05), body fat ratio, and abdominal obesity(p<0.01). The results of this study showed that the aqua exercise program to female patients with knee degenerative arthritis significantly increased the extension angle of the knee. Therefore it is thought that aqua exercise is an effective meditating method to improve their symptoms of female patients 50 years of age or older

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