Geriatrics & gerontology international
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Geriatr Gerontol Int · Apr 2010
ReviewWould the elderly be better off if they were given more placebos?
Placebos are useful in the medical care of the elderly, although the exact definition of a "placebo" or "placebo effect" is difficult to define precisely. They have an important role as control treatments in research trials, but a non-specific "placebo effect" may also be beneficial part of many physician-patient interactions. Physicians also give them deliberately according to several studies worldwide to satisfy patient demands or because they believe in a "placebo effect" among other reasons. ⋯ Placebos have often been considered a deception and thus unethical. On the other hand, some physicians and ethicists have suggested conditions for appropriate uses for placebos. A placebo might offer the theoretical advantage of an inexpensive treatment that would not cause adverse drug reactions or interactions with other medications, potentially avoiding complications of polypharmacy.
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Geriatr Gerontol Int · Apr 2010
Factors influencing death at home in terminally ill cancer patients.
The purpose of this study is to investigate factors affecting terminally ill cancer patients dying at home. ⋯ The results suggested the stronger involvement of families' preferences regarding the patients' place of death over patients' own preferences. Therefore, factors affecting families' preferences need to be clarified for the dissemination of death at home for terminally ill cancer patients.
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Geriatr Gerontol Int · Jan 2010
Emphysema on imaging is associated with quality of life in elderly patients with chronic obstructive pulmonary disease.
Limited data are available on the association between the severity of emphysema or airway narrowing, and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD), which has been seen to be more prevalent among elderly subjects. The aim of this study was to examine the association between HRQOL, physical parameters and structural alterations in lung of COPD patients. ⋯ We concluded that the severity of emphysema, but not that of large airway narrowing on HRCT, is associated with both generic and health-related QOL and reduced diffusion capacity. This notion might provide useful information in practice among elderly subjects who are unable to perform a spirometry.
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Geriatr Gerontol Int · Sep 2009
Case ReportsTranscatheter coil embolization for patent ductus arteriosus in the elderly: report of a case and review of the published work.
Patent ductus arteriosus is the third most common congenital cardiovascular anomaly, however, it is rarely found in the elderly. We describe a case of patent ductus arteriosus in a 72-year-old woman in whom patent ductus arteriosus was successfully managed by transcatheter coil embolization. The patient had been diagnosed with a heart murmur for the first time 1 year earlier at the age of 71. ⋯ Transcatheter coil embolization of the patent ductus arteriosus was successfully carried out with two 0.052-inch-diameter Gianturco coils. Doppler echocardiographic study confirmed no residual shunt in the main pulmonary artery after the procedure. Non-surgical transcatheter occlusion using coil embolization appears to be an effective and minimally invasive technique for treatment of patent ductus arteriosus in the elderly.
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To identify and evaluate the causes and characteristics of road traffic accidents (RTA) and to analyze injury patterns in elderly road traffic victims in order to apply appropriate measures for the prevention of RTA in the elderly. ⋯ The fragility of elderly car occupants and pedestrians should be taken into consideration and strategies aimed at the road-user safety including periodic medical screening, improvement of road structure and facilities, and the improved design of motor vehicles should be implemented.