Postgraduate medical journal
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An increasing number of elderly individuals are now undergoing coronary artery bypass surgery. Elderly patients, compared with patients of a younger age group, present for surgery with a greater burden of risk factors and reduced functional levels. ⋯ Therefore, an individualised risk-benefit profile must be carefully constructed by clinicians, taking into account several different factors and not just age alone. This review summarises the current concepts of coronary artery bypass surgery from the perspective of the very old.
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As a result of knowledge gained from the management of asthma with inhalers and nebulisers, pulmonary delivery devices for insulin have been developed. Particle size of the aerosol particularly influences drug delivery. ⋯ However, patient satisfaction does seem to be increased in patients taking inhaled insulins. Further studies are needed to investigate compliance, side-effect profiles, quality of life, long-term glycaemia control and cost effectiveness.