Aging (Milan, Italy)
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Aging (Milan, Italy) · Jun 1997
Postoperative delirium easily develops in patients with intramitochondrial inclusion bodies in colonic neurons.
Patients whose colons were resected for carcinoma were studied in order to determine the relationship between clinical findings-which included development of postoperative delirium- and intramitochondrial inclusion bodies (MI) in the neurons in the colon. Twenty-three patients had MI and 24 patients did not. Preoperative dementia was present in 9 (39.1%) of the 23 patients with MI, and in 7 (29.2%) of the 24 without it. ⋯ Excluding preoperative dementia, postoperative delirium developed in 5 (35.7%) of the 14 with MI, and in none of the 17 without it. Changes in the neurons in the colon were not related to dementia. The changes may have been related to the functions of the central nervous system, because patients with MI were likely to develop postoperative delirium.
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Aging (Milan, Italy) · Apr 1996
Infection surveillance and antibiotic utilization in a community-based skilled nursing facility.
To survey the types of suspect infections, the antibiotic utilization and the patterns of antibiotic resistance among bacterial pathogens in a community Skilled Nursing Facility (SNF), we conducted a 20-month prospective observational surveillance program comprising all 585 patients admitted to a 149-bed private community SNF. Data were collected form medical charts, laboratory reports and nurses reports. Overall, 41% of the patients developed at least one presumptive nosocomial infection, and 54% of the patients received one or more antibiotic treatments. ⋯ Most of the resistant S. aureus isolates were from indwelling catheter-associated with UTIs. Infections associated with quinolone resistant strains of gram-negative bacilli were infrequent. No epidemiologic evidence of nosocomial clustering was apparent.
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Aging (Milan, Italy) · Feb 1996
Aging effects on the perception of noxious and non-noxious thermal stimuli applied to the face.
While age-related sensory deficits have been demonstrated for the senses of vision, audition, and the chemical senses, reports have differed with regard to changes in painful and non-painful thermal sensation. One hundred and seventy-nine healthy, community-dwelling individuals aged 20-89 years rated threshold and suprathreshold warming, cooling, and painful stimuli delivered to glabrous (upper lip) and hairy (chin) sites of the face in three separate testing sessions. Threshold measures were determined by the Method of Limits. ⋯ The analyses of the effect of age on the threshold and suprathreshold measures of sensory performance yielded disparate findings. There are modest changes in warming and cooling perception with increased age, but pain perception is relatively unaffected. There is a slight diminution in threshold and suprathreshold thermal performance with increasing aging.
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Aging (Milan, Italy) · Oct 1995
A method for scoring the pain map of the McGill Pain Questionnaire for use in epidemiologic studies.
Identifying and quantifying the location of pain may be important for understanding specific functional impairments in elderly populations. The purpose of the present analysis was two-fold: first, to describe the reliability of a scoring method for the McGill Pain Map (MPM), and second, to validate the method of scoring the MPM as a tool for assessing areas of body pain in an epidemiologic study. In interviews performed at the subjects' homes, 411 community dwelling Mexican-American and non-Hispanic white subjects aged 65-74 from the San Antonio Longitudinal Study of Aging (SALSA) were asked to describe the location of their pain on the map of the human body included in the McGill Pain Questionnaire. ⋯ Among the 196 subjects with pain, correlations were: PPI (0.34), PRI (0.34), PH (0.19), ABP (0.21), PIW (0.38), and PPH (0.19)-p < 0.01 for all correlations. In conclusion, we have developed a reliable method of scoring the MPM and have shown evidence of its validity in a community-based sample of elderly subjects. Patterns of painful body areas may be associated with specific diseases and functional impairments.
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Aging (Milan, Italy) · Aug 1995
Comparative StudyOutcome of elderly patients requiring ventilatory support in intensive care.
The objectives of the study were: 1) to evaluate mortality in elderly patients requiring ventilatory support in Intensive Care Unit (ICU) and at 6, 12 and 18 months after discharge from ICU; 2) (main objective) to determine predictors of mortality in ICU and after discharge; and 3) to assess the life-style of survivors. One hundred and ten consecutive hospitalized patients > or = 70 years were included in this retrospective study. Follow-up evaluation was conducted by telephone interview. ⋯ Residence, health status, and self-sufficiency were evaluated after discharge. 1) Mortality in ICU and at 6, 12 and 18 months after discharge was 38%, 60%, 63% and 67% respectively. 2) The predictors of mortality in ICU were admission in shock, and use of major therapeutic interventions. Predictors of mortality at 6 months were admission in shock, previous impaired health status and marital status. 3) Eighteen months after discharge 92% of the surviving patients (N = 33) had the same residence, 75% had the same health status, and 78% had the same autonomy compared with pre-admission status. We concluded that shock and previous health status but not age are predictors of short- and long-term prognoses in elderly patients hospitalized in ICU for mechanical ventilation.