ORIGINAL_ARTICLE
Late life Depression: Prevalence, Pathogenesis, Clinical Presentation, Evaluation and Emerging Therapeutics
https://ejgg.journals.ekb.eg/article_5323_565a1b7d2d5bdb293b44c92e712787bf.pdf
2015-10-01
1
11
10.21608/ejgg.2015.5323
Hany
Hassanin
1
Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Determinants of the Motoric Subtypes of Delirium in Elderly
Background: Several studies have confi rmed the existence of three cl inical forms for del i r ium: hyperactive,hypoactive, and mixed, based on psychomotor behavior Aim: study the association between the psychomotor activi ty among di fferent del i rium subtypes and the admission characters in del i rious elderly patients to prove a hypothesis that hypoactive del i rium car ries worse underlying admission characters.Methods: A cross-s ec ti o nal s t udy w as c on duc te d on 4 5 ne wl y admi t te d del i ri o us el d erl y di agn os e d wi t h “C o nf us i on A s s es sm en t M et ho d ” CAM. Psychomotor activi ty was detected. Assessment of basel ine depression, function by Activi ties of dai ly l iving (ADL) , Inst rumental activi ties of dai ly l iving ( IADL), APACHE score and Erythrocyte sedimentation rate (ESR) were done.Results: Mean age was 71.2±7.9 years ( range 60.0 –91.0). 27 (60%) of patients were females. According topsychomotor characteristics, 19 (42.2%) of the participants were hypoactive, 13 (28.9%) were hyperactive and 13(28.9%) were mixed. Unl ike the hyperactive groups; the hypoac tive and mixed group have signi ficantly high ESR.There was no signi ficant association between motoric subtypes and presence of premorbid depression orfunctional dependence. There was no signi ficant di fference in basel ine comorbidi ties among the three sub types.Regarding the underlying etiology, Hypoglycemia was signi ficantly most f requent among hypoactive patients whi ledehydration was signi ficantly most f requent among patients wi th mixed type. APACHE score and the calculatedmortal i ty score were highest in hypoactive subtype and least among hyperactive, yet , this was of no statisticalsigni ficance.Conclusions: The hypoactive form of del i rium is common among older persons. Inflammation has a role in thepathology of hypoactive del i rium as indicated by hig h ESR. It is recommended to prompt ly recognize hypoactivedel i rium and to put a proper plan for ADL suppor t and functional rehabi l i tation.
https://ejgg.journals.ekb.eg/article_5324_9b5ac86e6fade17a147cb8e2591f339f.pdf
2015-10-01
12
17
10.21608/ejgg.2015.5324
del i rium subtypes- hypoactive- function- elderly- mortal i ty
Hamza
SA
1
Geriat rics and Gerontology Department , Facul ty of Medicine, Ain Shams Universi ty, Cai ro, Egypt.
AUTHOR
Ali
SH
2
Geriat rics and Gerontology Department , Facul ty of Medicine, Ain Shams Universi ty, Cai ro, Egypt.
AUTHOR
El-Mashad
NB
3
Cl inical Ppathology Depar tment , Facul ty of Medicine, Mansoura Universi ty, Dakahl ia, Egypt.
AUTHOR
El-sobki
HS
4
Geriat rics and Gerontology Department , Facul ty of Medicine, Mansoura Universi ty, Dakahl ia, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Circulating mRNA Lamin B1 for Detection of Early Stages of Hepatocellular Carcinoma
Background: Hepatocel lular carcinoma (HCC) is the fi fth most common cancer and the thi rd leading cause ofdeath worldwide, causing 600,000 deaths annual ly . In Egypt, HCC accounts for 4.7% of al l l iver diseases.Hospi tal -based studies have reported an overal l increase in the relative frequency of al l l iver cancers in Egyptfrom approximately 4% in 1993 to 7.3% in 2003, more than 95% of which being HCC . Patients diagnosed at anearly stage of HCC have the best prognosis, where resection and t ransplantation achieve the best outcomes inwel l -selected candidates, wi th a 5-year - survival rate of 50 to 70%. In this regard, the present study aimed todemonstrate the potential cl inical importance of plasma levels of ci rculating mRNA of lamin B1 by real -time RTPCR as an early marker of HCC. .Methods: This study was conducted at the Cl inical Pathology Department and the subjects were selected fromDepartment of Tropical Medicine and Infectious Diseases at Ain Shams Universi ty Hospi tals. It included thi r ty (30)HCC patients of di fferent stages (group I) , they were further divided into 3 stages using BCLC staging system intostage A, B and C, in addi tion to ten (10) cases wi th benign l iver diseases serving as patient cont rols (group II ) andten (10) heal thy age-and sex -matched subjects serving as heal thy cont rols (group III ) .Results: The plasma laminB1 mRNA showed a much bet ter performance to di fferentiate between HCC cases andthe 2 control groups, where i ts sensi tivi ty was 100% and speci fici ty was 90%.Conclusions: Addi tion of plasma lamin B1 mRNA to the cur rent standard tests for diagnosis of HCC as a newdiagnostic and screening tool . This, in turn, could greatly improve the abi l i ty to identi fy such patients and thuscould al low them to benefi t f rom earl ier t reatme nt.
https://ejgg.journals.ekb.eg/article_5325_4a919360c03c41a879f41b2acd4766db.pdf
2015-10-01
18
21
10.21608/ejgg.2015.5325
c i rc ul ati n g m R NA • ea rl y H CC • B CL Cs t agi n g s y s tem
Nasser
Rezk
1
Clinical Pathology Department, Faculty of Medicine, Ain Shams University.
AUTHOR
Mona
Osman
2
Clinical Pathology Department, Faculty of Medicine, Ain Shams University.
AUTHOR
Amira
Hamed
3
Clinical Pathology Department, Faculty of Medicine, Ain Shams University.
AUTHOR
Ashraf
Al- Breedy
4
Department of Tropical Medicine and Infectious diseases, Faculty of Medicine, Ain Shams University
AUTHOR
Hoda
Abd El – Sattar
5
Clinical Pathology Department, Faculty of Medicine, Ain Shams University.
AUTHOR
Amani
A. Ghani
6
Clinical Pathology Department, Faculty of Medicine, Ain Shams University.
AUTHOR
ORIGINAL_ARTICLE
The Accuracy of Physician View of Endpoint for Elderly Patient in ICU at Admission and Actual Discharge Outcome
Background: The average age and l i fe expectancy of the population are increasing and so a growing number ofelderly patients are being admi tted to the intensive care uni tAim: To detect the accuracy of the physician view of endpoint on ICU admission and actual discha rge outcomeMethods: A prospective cohor t study conducted on140 elder ly patients (60 years and above) admi t ted to medicalICU wi th acute i l lness, each patient was subjected to complete medical history, physical examination andassessment of medical comorbi di ties, ICU mortal i ty scores: (APACHE II , SAPS II , MPM II 0, MPM24) andcalculation of the predicted mor tal i ty, establ ishment of intensivist point of view regarding the predicted outcomeand establ ishment of end point of each patient (ei ther discharge o r death) .Conclusions: There is a highly signi ficant association between physician view of end point of the patient on ICUadmission and actual discharge of the patients in ICU
https://ejgg.journals.ekb.eg/article_5326_6fd7888f15df441369d5294f91ebe0e9.pdf
2015-10-01
22
25
10.21608/ejgg.2015.5326
Mor tal i ty prediction
Cri tical ly i l l elderly
ICU discharge
Ahmed
Shaheen
1
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Rania
Elakkad
2
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Manar
Mamoun
3
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Ahmed
Mortagy
4
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Empowering Role of Family Medicine Clinic in Geriatrics Care in a Rural Region in Egypt
Background: A gei ng h as b ec ome a m edi c al a nd s oc i al p ro b l em i n t od ay ’ s wo rl d. M os t el d erl y pa ti e nts ` fi rs t.contact is wi th non-geriat ricians, usual ly fami ly medicine physicians and primary heal th care providers.Aim: identi fy weak areas of geriat ric heal th care through elderly heal th status evaluation in an Egyptian rural areaand demonst rating pi lot heal th education prog ram regarding major geriatrics concerns.Methods: Cross-sectional study was done in the catchment area of the fami ly heal th uni t in El -Qal iobyaGovernorate in Kom-ashfeen vi l lage from July 2013 ti l l January 2014 on the elderly aging 60 years and above, 419elderly were enrol led. An interview questionnai re included socio -demographic data, basic activi ties of dai ly l ivings,and inst rumental activi ties of dai ly l ivings, mental status, and nut ri tional status. Hearing and visual status wereassessed. Screening for anemia, hyper tension and diabetes was performed. Heal th education program wasorganized. Completing and updating contents of the heal th folders of al l study subjects was done.Results: The mean age was 66.95±6.5 years. (56.6%) were males. The most commonly reported diseases wererheumatic diseases, ischemic hear t diseases and renal impai rment, respectively. 36.3% were unaware ofhypertension. 51 (12.9%) of subjects were diabetic by history, and 15.3% and 45.6% had fasting and post prandialhyperglycemia respectively discovered by screening. 83% of elderly females were anaemic. (57%) of the studysubjects were assisted by someone in some activi ties of dai ly l ivings. 31% of the subjects had mental problem.and (17%) were malnourished and 52% were at risk of malnut ri tion, and (28%) of the subjects had hearingproblem. 266 (63.5%) of study subjects were on a regular medication intake. The mean number of drugs taken was3.29 ± 1.7. 126 medical records had been created and 293 incomplete fi le were completed a nd activated.Conclusions: The study highl ighted service related areas for fami ly physicians to close the wide gap in geriat riccare by periodic heal th status assessment, screening for common chronic diseases, heal th education andcounsel ing programs.
https://ejgg.journals.ekb.eg/article_5327_0bc5e235f2b1990761d5f79ac460d2fb.pdf
2015-10-01
26
32
10.21608/ejgg.2015.5327
Fami ly medicine physician
geriat ric care
heal th assessment
Iman
Bakr
1
Community, Environment and Occupational Medicine Department- Faculty of Medicine- Ain Shams University
AUTHOR
Sarah
Hamza
2
Geriatrics and Gerontology Department, Faculty of Medicine- Ain Shams University
AUTHOR
Hanan
Ez-elarab
3
Community, Environment and Occupational Medicine Department- Faculty of Medicine- Ain Shams University
AUTHOR
Hebatullah
Hassan
4
Community, Environment and Occupational Medicine Department- Faculty of Medicine- Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Quality of Life and its Determinants after Stroke in Elderly Patients
Aim: This study was conducted to assess the impact of st roke on qual i ty of l i fe of elderly and to identi fy thedeterminant of QoL in geriatric stroke patients.Methods: A cross sectional study was per formed on 100 Pat ients wi th history of cerebrovascular st roke at leastthree months ago. Al l participants were subjected to complete medical history taking, cogni tive assessment: usingMini -Cog and assessment of qual i ty of l i fe by the short form 36 heal th survey (SF-36) in i ts Arabic versionResults: The cur rent study revealed that QoL of studied population was low wi th median score 34, and the mostaffected QoL domains were role l imi tation due to physical heal th (RLPH) and th at QoL was negatively cor related toage, duration, number of comorbidi ties and depression.Conclusions: HRQOL of elderly st roke patients is low, physical and emotional heal th is the mostly af fected. Mostdeterminant factor for QoL domains and sub domains was age.
https://ejgg.journals.ekb.eg/article_5328_aedf4b56a36aedb86650e24ad32d164f.pdf
2015-10-01
33
37
10.21608/ejgg.2015.5328
Qual i ty of Li fe
stroke
Elderl y
Sara
Sayed
1
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Ayman
El-Sudany
2
Neurology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Heba
Kamel
3
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Manar
Adel
4
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Sarah
Hamza
5
Geriatric Medicine& Gerontology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Adult Cardiac surgery in the elderly (octogenarians and above) - are we getting better?
Background: Cardiac surgery is being performed more f requently on the elderly. Wi th an over -stretched budget tocare for an aging population, our objective was to determine i f we are getting better at managing these frai lpatients.Methods: Insti tutional database was used to identi fy patients aged 80 or above undergoing cardiac surgery inBlackpool Victoria hospi tal NHS foundation t rust, UK between June1996 and June.2013. Outcomes between group1(June1996-Dec.2008; n=472) were compared to Gro up 2(Jan.2009-June.2013; n=607) . Long-term survival wasascertained using NHS t racing -service.Results: Group 2 patients included more males and had higher mean age and higher addi tive and logisticEuroSCORE I. Operative mor tal i ty was signi ficantly improve d whi le other compl ication rates were simi lar. Overal lmean long- term survival was 114.1±4.1 months.Conclusions: In the past 4 years despi te the tight NHS budgets we have been able to double our workload ofel de rl y pa ti en ts ’ p op ul a ti on a n d im pr ov e th ei r h ospi tal mortal i ty wi th expectation of good long -term survival .
https://ejgg.journals.ekb.eg/article_5329_2711bd6e4d482e775ae59afbd44948cc.pdf
2015-10-01
38
43
10.21608/ejgg.2015.5329
octogenarians
adult cardiac surgery
Faisal
Mourad
1
Dept. of Cardiothoracic Surgery, Ain Shams University, Cairo
AUTHOR
Vivek
Srivastava
2
Dept. of Cardiothoracic Surgery, Victoria hospital, Blackpool
AUTHOR
M.
Khan
3
Dept. of Cardiothoracic Surgery, Victoria hospital, Blackpool
AUTHOR
Andrew
Duncan
4
Dept. of Cardiothoracic Surgery, Victoria hospital, Blackpool
AUTHOR