J Formos Med Assoc
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Transnasal endoscopy (TNE) has been proven to reduce the need for intravenous anesthesia and the cost of the exams compared to conventional esophagogastroduodenoscopy (EGD) in adults. The objective of this study is to evaluate the benefits and the adverse effects of TNE in adolescents compared to conventional EGD. ⋯ Totally 15 patients, aged between 12 and 20 years old, who had undergone TNE for epigastralgia at National Taiwan University Hospital were recruited as the study group. Another 60 age and gender-matched adolescents were also recruited in the control group. The needs of conscious sedation (9.3% vs 58.3%), hospitalization rate (13.3% vs 43.3%), the mean exam time (7.34 vs 9.96 min), and the cost of endoscopy (57.6 vs 93.2 USD) were significantly lower in the group of TNE as compared with the conventional EGD group. There was no difference in the percentage of complications, including dizziness, epistaxis, nausea, and vomiting, after procedures (P > 0.05.) CONCLUSIONS: TNE is a cost-effective exam and it also reduces the exposure to conscious sedation, the need for hospitalization and the exam time, making it a good choice for adolescents who are scheduled to undergo EGD for epigastralgia.
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Many studies have examined the effectiveness of lifestyle modifications such as exercise, diet, weight loss, and stress reduction in controlling hypertension in elderly individuals, and several meta-analyses have reported that both aerobic and resistance exercise can reduce blood pressure in this population. In addition, the higher sensitivity to sodium in elderly individuals highlights the importance of restricting salt intake for blood pressure control. Low-sodium salt or potassium supplementation can help with blood pressure control in elderly individuals with hypertension. ⋯ Clinical studies have shown that weight loss through exercise and diet control is beneficial for controlling hypertension in elderly individuals. Anxiety, depression and insomnia also appear to have an impact on elderly hypertension. In this review, we discuss the effectiveness of lifestyle modifications and non-pharmacological management of these factors and their impact on hypertension in elderly individuals, and how to effectively implement them in real-world settings.