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Showing 10 results for Elderly

Ghodrat Akhavan Akbari , Masoud Entezariasl , Firooz Amani ,
Volume 6, Issue 3 (9-2006)

  Background and Objectives: Laryngoscopy and tracheal intubation could lead to hemodynamic responses in the from of hypertension and tachycardia as well as arrhythmia and myocardial ischemia. This alterations can be life-threatening particularly in elderly people. This clinical trial compared the effects of two rapid-onset narcotics, Alfentanil and Remifentanil, on the hemodynamic responses to the induction and tracheal intubation in elderly patients.

  Methods: This double-blind clinical trial was conducted on 40 subjects aged 65 and above. They were candidate of cataract surgery under general anesthesia. The patients were randomly allocated to two groups of 20. The first group, was gaiven Alfentanil 10 m g/kg and for second group Remifentanil 0.5 m g/kg was injected prior to the induction of anesthesia. Both groups were similiar in the method of anesthesia except in narcotics. The first group was infused with Alfentanil 1 m g/kg/min and Remifentanil 0.1 m g/kg/min was used for the second group. Hemodynamic variations including heart rate, systolic, diastolic and mean arterial blood pressure were measured and recorded eight times (before induction, aften injection, after intubation and five times during anesthesia). Data were analyzed with SPSS software using descriptive and analytical statistics such as T-test, chi squre and ANOVA.

  Results: Immediately after injection of narcotic drugs, all hemodynamic variants decreased. Howerver diastolic blood pressure in Remifentantil group significantly more than Alfentanil group (P<0.05). After laryngoscopy and tracheal intubation all hemodynamic variants increased and slowly decreased in less than 10 minutes. Systolic, diastolic and mean arterial blood pressure decreased significantly in remifentanil group than alfentanil group (P<0.05). Although heart rate decreased during few minutes after intubation, there was not significant difference between two groups regarding this decrease (P>0.05). Ephedrin was used to treat severe hypotention in those under Remifentanil (11 patients) more than those under Alfentanil (4 patients) (P<0.05).

  Conclusions: According to the resukts of this study Remifentanil could prevent hemodynamic variation induced by laryngoscopy and treacheal intubation more than Alfentanil. However in some cases Remifentanil leads to hypotension during anesthesia. There is no important difference between two drugs in increasing heat rate after laryngoscopy and intubation.

Masoud Entezariasl, Ghodrat Akhavan Akbari , Khatereh Isazadeh Far,
Volume 7, Issue 4 (12-2007)

  Background & Objective: With consideration the daily increased development of outpatient surgeries and high rate of these operations in elderly patients, rapid and safe recovery of patients for coming back to daily life is necessary. In this clinical trial study recovery time and nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in elderly patients has been compared.

  Methods: In this double-blind clinical trial 40 elderly patients (age above 65) candidated to cataract surgery with general anesthesia were studied. The patients were divided randomly into two groups and for first group alfentanil was injected 10 m g/kg and for second group remifentanil 0.5 m g/kg during 30 seconds one minute before induction. Both two groups were under general anesthesia with same method and during the anesthesia first group took infusion of alfentanil 1 m g/kg/min and second group remifentanil 0.1 m g/kg/min. At the end of surgery the time intervals between end of anesthesia drug adminstration and autonomic respiration, eyes opening with stimulation, verbal response and discharge of recovery room, also the incidence of complications related to narcotic drugs especially nausea and vomiting were recorded. The data were analyzed in SPSS software using descriptive and analytical statistics as T-test, chi square and ANOVA.

  Results: The time of autonomic respiration in alfentanil group was 2 minutes and in remifentanil group 3.3 minutes,this time in alfentanil groupe1.3 minutes shorter but the difference was not significant. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different. During recovery incidence of nausea and vomiting in remifentanil group (30% of patients) was significantly more than alfentanil group (5% of patients) (P<0.05).

  Conclusion: The time of recovery between alfentanil and remifentanil group was not significantly different, but incidence of nausea and vomiting in remifentanil group was higher than alfentanil group significantly.

Aghil Habibi, Soghra Neekpoor, Mahnaz Seyedolshohda, Hamid Haghani,
Volume 8, Issue 1 (4-2008)

Background & Objective: As life expectancy increases health promotion behaviours are even more important, particularly with regard to maintaining functional independence and improving quality of life (QoL). The purpose of this study was to explore the relationship
between health promotion behaviours and quality of life among elderly people in west region of Tehran.
Methods: This was a descriptive-correlational study. Through multi-stage sampling method, 410 participants over 60 years old and cognitively intact were selected to contribute in the study. The data-gathering tool consisted of a 2-part questionnaire Health Promotion Behaviour Checklist and Short Form Health Survey (SF12) that were used to measure QoL.
Results: The results of the study showed that there were statistically significant differences in QoL of the elderly related to 'exercise or walking and consumption of milk, dairy products, meat, vegetables and fruits and 'low salt diet', 'low fat diet', 'health check up', 'blood pressure (BP) (p< 0.05). The Elderly with high quality of life had more exercise or walking and consumption of milk, dairy products, meat, and fresh fruit and vegetables and the elderly with low quality of life, had better observed low salt diet, low fat diet, health condition control and blood pressure control.
Conclusion: Regarding the results we found that health promotion behaviours and the quality of life are related meaningfully, so, considering old people as a vulnerable group by health authorities, it is recommended to provide this group with programs and facilities to promote their health behaviours, social participation and to improve health care and provide consultation services.
Bita Shahbazzadegan , Rabiollah Farmanbar, Atefeh Ghanbari , Zahra Atrkar Roshan , Masoumeh Adib ,
Volume 8, Issue 4 (12-2008)

  Background & Objectives: With regards to the importance of health and Quality of Life improvement in the elderly in relation with physical activity and self esteem, the aim of this study was to determine the effect of programmed exercise on the self esteem of elderly residents in the nursing home of Rasht city in 2008.

  Methods: This study included a pretest and post test on 32 qualified samples. The Rosenberg self esteem scale were filled by them. Then, they attended a programmed exercise for one month. The scale was filled again by participants. The collected pre-test and pot-test data were analyzed using a-t-test SPSS software.

  Results: The average age of the participants was 73.53 (± 8.31). Most of them were widowed, 43.8% had no children, 87.5% were uneducated and the rest (12.5%) had a primary level of education. 37.2 of them had resided in the nursing home for less than one year and their average of residence was 1357±17.11 days. The source of income for 59.4% of participants was through children and relations. 27 persons (84.4%) had frequent visits with relations. 34.4% of them had a disease in history. There were significant correlations between number of children, marriage, education and job and number of previous jobs, gender job and education and number of previous job, visit frequency and education and time of the last visit. The correlation between sums of self esteem scores before and after the exercise was positive and significant and 22.81±4.84 Average of self esteem score before and after programmed exercise was 26.84±4.35.

  Conclusion: Regular exercise is effective in improving the self-esteem among the elderly and it can recommend to the elderly as a safe and cheap method.

Amin Moradi , Bahareh Pahlavan , Ali Sadigi, Yasamin Pahlavan ,
Volume 12, Issue 1 (4-2012)

  Background & Objectives: Severely comminuted distal femur fractures are in association with the high complications and their treatment is so difficult. Supracondylar femur fractures usually occur as a result of low-energy trauma in osteoporotic bone in elderly persons or high-energy trauma in young patients. This study was aimed to assess the results of new treatment plan for comminuted intra-articular distal femur fractures with locking condylar buttress plate. The results of this strategy will help us to find the effective method of treatment for the distal femur fractures.

  Methods: In a prospective cross-sectional study, 47 patients with intra-articular distal femur fractures after two weeks fracture and treating with locking condylar buttress plate were selected. Then, they were examined for infection, range of knee motion and ::union:: at the first and second week and 1, 2 and 3 months after surgery. The data were analyzed by descriptive statistics and the level of significance was set as p<0.05.

  Results: 53.2% of the patients had closed fractures, 6.4% of them had open type I and the rest showed open type IIIA fracture. The overall ::union:: rate was seen in 80.9% of cases and infection was detected in 19/1% and mal::union:: was observed 21.3% of patients. The mean degree for range of motion was 105.74 ±24.47 and the maximum degree of extension was 20.

  Conclusion : Complete fixation for distal femur fracture type C3 was achieved by buttress plate and using this locking condylar plate was association with less complication such as infection, mal::union:: and non-::union::.

Gholamreza Irajian , Reza Mirnejad, Mohammad Reza Jalali Nodoshan, Nafiseh Ghorbanpour,
Volume 13, Issue 1 (4-2013)

  Background & Objectives: Prostatitis is relatively one of the common diseases in elderly men. Treatment of this disease is difficult and because of frequent relapses, it provides complicated problems for patients and the physicians. Detection of reservoirs and determination of prevalence of involved microbes in prostatitis are important in the epidemiology and control of the disease. This study was conducted to determine the prevalence of Mycoplasma genitaliumin patients with prostatitis by sequencing and PCR-RFLP techniques.

  Methods : In this cross-sectional study, 200 paraffin-embedded prostate samples from patients with prostatitis during 2008-2011 were checked for M. gentialium. After cutting the tissues and homogenization, the genomic DNA was extracted and used as template in PCR. Primers targeting a 465 bp regions of 16S rRNA of M. genitalium were used in the assay. PCR products were sequenced and Cac8I, Bbs I, EcoRI, AluI, TaqI endonucleases were used in RFLP analysis.

  Results : Of 200 samples, 4 were positive in PCR. The results of DNA sequencing and RFLP confirmed the amplified genes corresponded to M. genitaliumG37.

  Conclusion : The Mycoplasma genome present in tissue samples of prostate showed this bacterium could be one of the risk factors for prostatitis in men. However large studies and control groups are needed to prove this finding.

Behnood Abbasi , Masoud Kimiagar, Shahriyar Shahidi , Minoo Shirazi, Khosro Sadeghniiat, Mahdi Hedayati , Bahram Rashidkhani,
Volume 13, Issue 2 (6-2013)

  Background & Objective: Advances in public health and control of infectious diseases have led to increased number of elderly people in the world including Iran. Thus serious concerns exist in terms of age-related diseases . Consequently, Iran’s ministry of health has chosen “ageing and health” as the theme for 2012 along with WHO. Psychological disordersare among the most prevalent diseases in elderly people. Recent studies suggest a two-way relationship between some psychological disorders and insomnia. Also there is evidence implying magnesium role in improvement of aforementioned disorders. The objective of this study was to determine the effects of dietary magnesium supplementation on mental health in insomniac elderly subjects.

  Methods: A double-blind randomized clinical trial was conducted on 46 insomniac elderly subjects randomly allocated into the magnesium or the placebo group, receiving daily for 8 weeks either 500 mg magnesium or a placebo, respectively. SCL-90-R and ISI questionnaires were conducted at baseline and at the end of the intervention period. Serum magnesium and cortisol levels were also determined in the patients. In addition, information was obtained on anthropometric confounding factors and daily intake of magnesium, calcium, potassium and caffeine using 24-hr dietary recall questionnaire for 3 days. The N4 and SPSS19 were used for data analysis.

  Results: No significant differences were observed in assessed variables between the two groups at baseline. As compared to the placebo group, in the experimental group, dietary magnesium supplementation brought about statistically significant decreases in GSI, PST, PSDI, ISI scores as well as somatization , anxiety, psychoticism , and depression symptoms and serum cortisol concentration. While the obsessive-compulsive , interpersonal sensitivity, hostility , phobic anxiety, paranoid ideation scores and serum magnesium concentration were not different between the experimental and the placebo groups.

  Conclusion: In this study dietary magnesium supplementation resulted in improvements in insomnia severity index and some indices of mental health.

Mir Mohammad Taghi Mortazavi, Masoud Niazi, Naser Rezapour, Masoud Parish,
Volume 15, Issue 4 (1-2016)

Background & objectives: Surgery of upper part of femor in elderly patients can be due to the fracture of femoral neck, shaft and arthroplasty. Hemodynamic changes and complications of the anesthesia are among the major concerns. The aim of this study was to compare the hemodynamic changes in low dose isoflurane with propofol in upper femoral surgeries in elderly patients.

Methods: This prospective clinical trial study was done on 60 patients over 65 year-old elderly patients with ASA physical status of I and II that were candidate for upper femoral surgery in two groups (inhalational: isoflurane 0.5-0.6 MAC) and (total intravenous anesthesia with propofol 50-100 mic/kg/min). Hemodynamic changes were compared in these groups with the same anesthetic depth (HR-SBP-DBP-MBP-SaO₂).

Results: There was no significant difference in heart rate, age or sex between two groups. In isoflurane group SBP on 20 and 25th minutes and DBP and MBP on 20, 25 and 35th minutes were significantly higher than propofol group. In propofol group SaO₂ was significantly more than isoflurane group on induction, start of surgery and on 5, 25, 35 and 45th minutes of surgery.

Conclusion: In anesthesia with the same Bi-Spectral Index, isoflurane provides more stable hemodynamic parameters than propofol.

Shadi Shahsavan, Abdolaziz Rastegar Lari , Bita Bakhshi, Parviz Owlia, Maliheh Nobakht ,
Volume 16, Issue 3 (10-2016)

Background & objectives: Shigella spp. are gram negative bacteria that can cause shigellosis in human. It is important in young children as well as elderly and immunocompromised people. Threatening complications can occur in severe cases with multidrug resistance species. It has been observed that Shigella spp. have become resistant to antibiotics like other bacteria. Investigation of resistance to azithromycin, tetracycline and pattern of resistance are the objectives of this study.

Methods: Fifty isolates of Shigella spp. which have been collected from three hospitals in Tehran were studied. Isolates identified and confirmed as Shigella spp. by biochemical, serological and molecular methods (ipaH, wbgz, rfc genes). Antimicrobial susceptibility test was performed for ampicillin, azithromycin, ciprofloxacin, doxycycline, levofloxacin, minocycline, nalidixic acid, norfloxacin, streptomycin, trimethoprim-sulfamethoxazole and tetracycline by disc agar diffusion method. Minimal inhibition concentrations were performed for azithromycin and tetracycline.

Results: From a total of 50 Shigella spp. isolates, 16% of them were Shigella flexneri and 84% Shigella sonnei. The majority of isolates were multidrug resistant. The most resistance was seen to doxycycline, streptomycin, trimethoprim-sulfamethoxazole and tetracycline. Resistance to azithromycin was 6%  and all of the isolates were susceptible to norfloxacin and levofloxacin. Nine patterns of resistance were revealed to these isolates.

Conclusion: High resistance to tetracycline was observed and resistance to azithromycin as an alternative treatment choice was also considerable.

Mohammad Amani,
Volume 16, Issue 4 (1-2017)

Alzheimer's disease (AD) is a common cause of dementia in elderly people that is accompanied by progressive cognitive decline and memory loss. The pathologic hallmarks of AD are synaptic and neuronal degeneration together with extracellular senile plaques containing amyloid-beta (Aβ) and the intracellular neurofibrillary tangles (NFTs) in the hippocampus and other cortical regions. Amyloid-beta peptide is believed to have a pivotal role in the pathogenesis of AD as a major component of the senile plaques. It acts as a trigger key of AD and is considered as the principal toxic factor in the pathogenesis of the disease. Accumulation of amyloid β protein (Aβ), a main component of the senile plaques, in the brain initiates a cascade of events that ultimately lead to neuronal dysfunction and cognitive deficits. Other proposed mechanisms for AD include impairment in cholinergic function, oxidative stress, inflammatory agents and glutamate-mediated excitotoxicity. AD is characterized neuropathologically by impaired cholinergic function, increased oxidative stress, neuroinflammation, neuronal cell death, synapses loss, cortical atrophy, deficiencies in steroid hormones and appearance of glutamate-mediated excitotoxicity.

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