The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Sep 1996
Suppression of first pain and slow temporal summation of second pain in relation to age.
Thermal stimuli delivered to skin of the arms or legs can produce a sensation of two distinct pains. These pains have been associated with activity in A-delta (first pain) and C-fiber (second pain) nociceptive fibers, respectively. Under appropriate conditions first pain decreases in intensity (adaptation) while second pain increases in intensity (slow temporal summation). Change in first and second pain to repeated stimulation of skin has not been assessed in relation to age. ⋯ Age did not influence pain intensity to unadapted and unsensitized skin. Slow temporal summation of second pain was not observed at the leg in the older group, suggesting that mechanisms subserving C-fiber mediated sensitization of second order nociceptive neurons may fail with age. Longer response times to first, but not second pain in older subjects may represent an age effect on myelinated (A-delta; first pain) and not unmyelinated (C-fiber; second pain) nociceptive afferents and may represent a type of small fiber peripheral neuropathy.
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J. Gerontol. A Biol. Sci. Med. Sci. · May 1995
Randomized Controlled Trial Clinical TrialCost-effectiveness of low-air-loss beds for treatment of pressure ulcers.
Cost-effectiveness of low-air-loss beds for the healing of pressure ulcers was analyzed in the nursing home setting. A statistical model of pressure ulcer healing was used to estimate cost-effectiveness based on patient and ulcer characteristics. ⋯ Findings support the expanded use of this technology for patients with mild pressure ulcers and good healing characteristics. For these patients, the cost-effectiveness of low-air-loss beds is comparable to other accepted health treatments. For patients with severe ulcers and poor healing characteristics, low-air-loss bed cost-effectiveness compares poorly with other accepted health treatments unless the lease cost can be substantially reduced, or unless life with a pressure ulcer is valued close to death.
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J. Gerontol. A Biol. Sci. Med. Sci. · Mar 1995
Benzodiazepine use as a cause of cognitive impairment in elderly hospital inpatients.
Benzodiazepine drugs are used very frequently by the elderly and have been associated with a number of untoward events in them. In an earlier publication, we showed that there was an association between benzodiazepine use and episodes of confusion in hospital. The purpose of this study was to examine that association in more detail by studying only patients with intact cognitive function on admission and by taking into consideration a range of demographic, drug use, and clinical confounders. ⋯ Elderly hospital inpatients who have intact cognitive function on admission to hospital have a low risk of developing cognitive impairment and delirium during their hospital stay. In this population, however, benzodiazepine use accounted for 29% of cases of cognitive impairment which did occur. The data also suggest that dehydration, urinary retention, and an admission diagnosis of CNS disease may be important risk factors for delirium.