Diana Galindo

Continuous Compared With Intermittent Tube Feeding in the Elderly

The methods of continuous (C) and intermittent (I) nasogastric tube feedings in 60 patients, 54 men and 6 women, with a mean age of 72 +/- 9 years were compared in terms of number of complications, staff time used, and caloric intake. Patients were randomly assigned between these two methods and followed for 7 days. Diarrhea, aspiration pneumonia, clogged tubes, and self-extubation were observed in both groups. Diarrhea was significantly more frequent (96% of 30 patients) in the I group than the C group (66% of 30 patients) (p < .008). Furthermore, diarrhea was more prolonged (4 days or more) in 64% of 30 patients in the I group than the C group (4 days or more) in 58% of 30 patients (p < .02). However, clogged tubes occurred 3 times more often in the C group (p < .01). Self-extubation and aspiration pneumonia tend to be more frequent in the I group but the difference was not significant. The average time used by staff nurses in the maintenance of NGT feedings was not significantly longer in the I group (48.45 +/- 11 min/patient per day) than the C group (46.46 +/- 11 min/patient per day). In the C group the mean calories recommended were 2248 +/- 36 kcal/day but the actual caloric intake was only 1465 +/- 281 kcal/day, a deficiency of 783 +/- 291 kcal/day. The recommended calorie count for the I group was 2021 +/- 5 kcal/day but the amount delivered was only 1226 +/- 254 kcal/day, which resulted in a deficit of 795 +/- 259 kcal/day.(ABSTRACT TRUNCATED AT 250 WORDS)

Caudal Epidural Blocks for Elderly Patients with Lumbar Canal Stenosis

Objective: To determine the efficacy of caudal epidural blocks (CEB) in relieving pain and the duration of pain relief with CEB in elderly patients suffering from degenerative lumbar canal stenosis (LCS).

GAIT TRAINING AND FALLS IN THE ELDERLY

1. Patients with gait and balance disorder, as measured by the Tinetti Mobility Scale, can benefit from physical therapist-assisted gait training. 2. Score in the Tinetti Mobility Scale negatively correlates with the number of recurrences of falls. 3. The nurses role includes identification of those who are at risk for falls, assessment of their response to training in preventing recurrence of falls, and the effect of training in their mobility and independence.

A Comparison Between Aspirin and Pentoxifylline in Relieving Claudication Due to Peripheral Vascular Disease in the Elderly

Peripheral vascular disease (PVD) commonly presents with leg claudication during walking and eventually limits the walking distance and daily activities. Aspirin or pentox ifylline are commonly prescribed to improve blood flow. Aspirin works through its antiplatelet aggregation mechanism, and pentoxifylline increases the red blood cell flex ibility, which leads to increased tissue perfusion. Data on comparative studies of these drugs for improving claudication in the elderly are limited. The objective of this study was to compare pain relief offered by either aspirin or pentoxifylline for walking leg pain in the elderly with PVD. Patients sixty-five years or older with claudication were randomly assigned to receive aspirin or pentoxifylline. Their reported level of walking claudication pain with use of the visual analogue scale (0-5) and the distance walked during exercises were recorded. Six weeks later the same parameters were recorded and results were compared with Students t test, and a P value less than 0.05 was considered a statistically significant difference. Of the 90 patients who participated, 45 received aspirin (325 mg daily) and 45 were prescribed pentoxifylline (400 mg tid) for six weeks. Both the aspirin and the pentoxifylline groups reported a moderate level of pain (2/5) and remained about the same (2/5 for aspirin and 1/5 for pentoxifylline, P = 0.9, NS) after six weeks. However, the pentoxifylline group reported a farther walking distance of 2 miles compared with the aspirin group of 1.2 miles (P < 0.05). The level of pain did not change significantly with either aspirin or pentoxifylline, but the walking distance was farther with the pentoxi fylline group.

Nocturia in the elderly: a wake-up call.

Nocturia is a condition that health providers must seek out and address in older adults. Since it adversely affects quality of life and carries a risk of morbidity and of death (often because of falling), this symptom must be elicited during the physician-patient encounter. Understanding its underlying causes, risk factors, and consequences is essential in formulating the most suitable management strategy. Drug and nondrug treatments target the individual disorders that contribute to nocturia. Nocturia is common, but elderly patients infrequently volunteer this complaint, and even when they do, some clinicians may dismiss it.

REDUCING NURSING HOME POLYPHARMACY USING SYSTEMATIC MEDICATION AND ASSESSMENT REVIEW AND TRACKING: THE SMART PROGRAM

early detection and treatment of the disease. Clinical characteristics of hepatitis E in older adults of influenza-like symptoms were barely observed before hepatitis occurred ( 13.5%). Most patients developed jaundice (92.8%), and 50.5% exhibited severe jaundice, with peak values of total bilirubin (TB) 10 times or more the upper limit of normal (ULN). For these reasons, many patients stayed in the hospital for a long time (54.1% 430 days). In addition, many people had cholestasis (66.7% with conjugated bilirubin (CB)/TB 70%); thus, they were often misdiagnosed with obstructive jaundice and were required to undergo computed tomography or magnetic resonance cholangiopancreatography, which caused unnecessary expenses. Older adults have obvious liver degeneration, with less compensation capacity and slower hepatocyte proliferation than younger people. Our results confirmed that hepatitis E in older adults results in a high incidence of low albumin (46.8%). Hepatitis E is believed to exacerbate diseases in older adults, with high rates of liver failure and mortality, although the current study found that only three individuals (2.9%) had minimal prothrombin activity (PTA) values less than 40%, and mortality was low (n 5 1, 0.9%). Most scholars believe that hepatitis E superinfection will exacerbate hepatitis B, but the current results showed that only one case exhibited a peak value of TB 10 times ULN or greater. This investigation revealed 21 cases of alcohol drinkers with peak values of TB 10 times ULN or greater, and one case showed a minimal PTAvalue of less than 40%. Thirty-five cases without alcohol intake showed peak values of TB 10 times ULN or greater, and two cases showed minimal PTA values less than 40%. No statistically significant difference was observed. Therefore, hepatitis E does not exacerbate alcoholic liver disease. In summary, hepatitis E in older adults in the Wenzhou area of China has its own epidemiological, clinical, and laboratory characteristics.

Baseline Characteristics and Outcomes of Older Adults Seeking Care in Ambulatory Urgent Care Clinics

To determine the most common clinical conditions associated with older adults visiting Urgent care centers (UCCs) and the potential need for further resource use.