Nihon rinsho. Japanese journal of clinical medicine
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The aged patients are susceptible to respiratory failure, especially acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The mortality rate for ARDS ranges from 40-70% despite of intensive care using currently available drugs. ⋯ Recent studies using genetically-engineered mice have shown that PAF and cytosolic PLA2 (cPLA2) play an important role in the pathogenesis of ALI. The inhibition of these pathways, PAF and cPLA2, might provide a novel therapeutic approach to ALI.
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Number of elderly patients undergoing surgery is increasing in Japan owing to the increasing population over 65. Developments of less invasive surgical techniques and advances in perioperative care may also contribute. ⋯ Postoperative complications in the elderly, including pneumonia, aspiration, myocardial infarction, delirium, cognitive dysfunction and cerebral infarction are described. Management and preventive strategies of postoperative complications are also discussed.
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Many factors such as the environmental conditions (temperature and humidity etc.), a nutritional status, the degree of fatigue, a moisturizing state of the body, clothes, the sensitivity to coldness are involved in an outbreak of hypothermia. Children, aged persons and the presence of an underlying disease are also risk factors related to the occurrence of hypothermia. ⋯ Frostbite develops when tissue is exposed to -4 degrees C of coldness or lower. The extent of injury is determined by the magnitude of coldness.
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Sudden death during bathing accounts for 10 to 15% of all out-of hospital cardiac arrests in Japan. Surveys in Tokyo revealed 1,085 victims of accidents during bathing transported by ambulance from October 1999 to March 2000. 53% of them were cardiac arrest and 25% were those who needed rescue from bath tub because of consciousness disturbance (rescued group). ⋯ The current hypothesis of the accidents during bathing is a unique type of heat illness exposed by high water temperature(41-43 degrees C). Geriatric population is vulnerable to the bathing induced heat illness.
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Review
[Characteristics of elderly heat illness patients in Japan--analysis from Heatstroke STUDY 2010].
Heatstroke Surveillance Committee of the Japanese Association for Acute Medicine (JAAM) collected the clinical data of 1,775 heat illness patients transported into 94 Emergency Medical Centers or Emergency Departments throughout Japan from 1 July to 31 August 2010 (Heatstroke STUDY 2010). Seven hundreds and four elderly patients' data revealed that 541 cases (80%) suffered from classical heatstroke in the ordinary life and the morbidity and mortality were much higher than those of exertional heatstroke patients. ⋯ Forty nine patients (6.9%) were the victims of classical heatstroke and multiple organ failure include heart failure was the major cause of heat related death in acute phase after admission. No one died in exertional heatstroke group.