Clinical interventions in aging
-
The aim of this paper is to investigate whether bioelectrical impedance vector analysis (BIVA) can be a suitable technique for the assessment of sarcopenia. We also investigate the potential use of specific BIVA as an indicator of sarcopenic obesity. ⋯ BIVA detected muscle-mass variations in sarcopenic individuals, and specific BIVA was able to discriminate sarcopenic individuals from sarcopenic obese individuals. These procedures are promising tools for screening for presarcopenia, sarcopenia, and sarcopenic obesity in routine practice.
-
This study aimed to determine the safety of diclofenac sodium topical solution 1.5% (w/w) in 45.5% dimethyl sulfoxide (TDiclo) for the treatment of knee or hand osteoarthritis in persons aged 75 years or older. ⋯ TDiclo appears to be well tolerated for the treatment of osteoarthritis in persons aged 75 years or older.
-
Average life expectancy has increased over the past century, leading to a larger proportion of elderly in the population. Comorbidity and dependence increases with age, and recent data have shown that the number of elderly patients admitted to intensive care is increasing. This has implications for the availability of health care for these patients, as health care is a finite resource. ⋯ Compared to the results of previous studies, an increase in the number of medical treatments in the intensive care units of patients aged over 90 years over the study period could not be found.
-
Intra-articular corticosteroid and hyaluronic acid injections provide short-term symptom amelioration for arthritic conditions involving structural damage or degenerative changes in the knee. Conventional palpation-guided anatomical injections frequently result in inaccurate needle placement into extra-articular tissue and adjacent structures. The purpose of this review was to determine the effect of ultrasound guidance on the accuracy of needle placement, clinical outcomes, and cost-effectiveness in comparison with anatomical landmark-guided intra-articular large joint injections, with particular emphasis on the knee. ⋯ In particular, ultrasound guidance of knee injections resulted in better accuracy than anatomical guidance (95.8% versus 77.8%, P < 0.001), yielding an odds ratio of 6.4 (95% confidence interval 2.9-14). Ultrasound guidance notably improves injection accuracy in the target intra-articular joint space of large joints including the knee. The enhanced injection accuracy achieved with ultrasound needle guidance directly improves patient-reported clinical outcomes and cost-effectiveness.
-
Laminectomy/laminotomy and foraminotomy are well established surgical techniques for treatment of symptomatic lumbar spinal stenosis. However, these procedures have significant limitations, including limited access to lateral and foraminal compression and postoperative instability. The purpose of this cadaver study was to compare bone, ligament, and soft tissue morphology following lumbar decompression using a minimally invasive MicroBlade Shaver® instrument versus hemilaminotomy with foraminotomy (HL). ⋯ The iO-Flex system resulted in significantly better decompression of the lateral recess and foraminal areas compared with HL, while preserving posterior spinal elements, including the facet joint.