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Problems of anticoagulant therapy in elderly cancer patients with atrial fibrillation and hemorrhagic stroke

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Ballyuzek M. F., Mashkova M. V.
OncoReview
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2017
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vol. 7
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issue 4
168-170
EN
The problems of antithrombotic and first of all, anticoagulant therapy in patients with concomitant oncological and cardiovascular pathology, especially in gerontological practice, remain to be unsolved. The need to use anticoagulants is dictated by a high risk of thromboembolism in cancer patients combined with age-associated atrial fibrillation. The risk of hemorrhage increases with the age; moreover, there is a risk of dangerous drug interactions due to the need of polymorbid pathology treatment. Thus, the clinical situation sometimes creates difficulties in choosing a proper tactic in patient management and following the existing treatment standards. A clinical case of a patient of an elder age with the recurrence of lung cancer, which has an established high-risk of thromboembolism, and with paroxysmal form of atrial fibrillation and new oral anticoagulants treatment, is considered.
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Treatment of acute appendicitis in geriatric patients – literature review

100%
Kot A., Kenig J., Wałęga P.
Polish Journal of Surgery
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2016
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vol. 88(3)
136-141
EN
Demographic changes associated with the aging population mean that surgeons increasingly have contact and make decisions about treating patients from the oldest age groups. The aim of the study was to review the literature concerning the treatment of acute appendicitis in patients over the age of 60 years old. Material and methods. A review of the literature published in the years 2000-2015 has been carried out using the PubMed database. The initial number of results corresponding to the query in English, „appendicitis (MeSH) AND elderly (MeSH)” was 260. Selection based on the titles, abstracts, and eventually whole articles, ultimately resulted in 11 papers concerning the treatment of appendicitis in patients above 60 years of age. Results. Nine papers were retrospective and 2 were prospective. In total, the studies included 82,852 patients. Laparoscopic appendectomy was associated with a lower mortality rate, a smaller number of postoperative complications and a shorter length of hospital stay, which led to it being recommended by most authors. Four of the ten papers demonstrated that the patients who were qualified for laparoscopic surgery had less comorbidity and were in a lower ASA (American Society of Anaesthesiology) category. Antibiotic therapy as an independent method was assessed in one study in a group of elderly people, on a selected group of 26 patients, and its effectiveness was shown to be 70%. Most studies, however, are highly heterogeneous which significantly hindered comparisons. Conclusions. Currently, laparoscopic appendectomy seems to be the treatment of choice in the elderly with acute appendicitis. Antibiotic therapy, as an independent method of treatment of acute appendicitis, cannot currently be recommended. However, further, prospective, and better-designed studies are needed, involving a larger number of patients, and primarily dedicated to the elderly.
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The Role of Fall Prophylaxis in the Quality of Life of the Geriatric Patients

75%
Nadobnik F.
Central European Journal of Sport Sciences and Medicine
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2021
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vol. 33
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issue 1
43-52
EN
Elderly people are not only more susceptible to disease, but they are also at a higher risk of sustaining accidents such as falls, which definitely affects the quality of human life. Aging, in other words, carries with it an increased danger of illness and injuries, including those caused by falling. Research referred to in this article consisted in collecting and analyzing anonymized data of 411 geriatric patients admitted to a hospital in Berlin, Germany, over a period of six months, between January and June 2020, and attempted to look at how fall prophylaxis can reduce the overall healthcare costs generated by senior citizens. Of the 411 geriatric patients, 105, aged between 49 and 97 (69 females and 36 males), sustained injuries due to falling and made up 34.3% of all geriatric patients. Conclusions that the author arrived at can prove useful to determine the importance of the prevention of falls of older people in reducing the complications resulting from falls. The overall costs of senior citizens' health care were also taken into consideration. Therefore, solutions should be sought to reduce the number of falls of older people. Falls are an important public health problem causing suffering for elderly patients, worsening the comfort of further life and additionally generating relatively high costs for the economy.
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