Farmakoterapia zaburzeń psychicznych u chorych w podeszłym wieku jest często trudna i ograniczona powszechniejszym niż u młodszych chorych występowaniem objawów niepożądanych, interakcji lekowych ...oraz koniecznością brania pod uwagę współchorobowości, nie tylko psychiatrycznej, ale przede wszystkim – somatycznej. Te aspekty, razem z wieloczynnikową patogenezą zaburzeń i znaczną w wielu badaniach odpowiedzią placebo, prowadzą do względnie niższych wskaźników efektywności klinicznej leczenia. Właściwy wybór leku, uwzględniający jego skuteczność i bezpieczeństwo, jest zatem kluczowy dla sukcesu terapii. Escitalopram to obiecujący lek dla starszych chorych. Jego znaczna selektywność farmakodynamiczna, korzystny profil farmakokinetyczny, w tym stosunkowo niewielki potencjał wchodzenia w interakcje lekowe, oraz dość rzadkie wywoływanie poważnych objawów ubocznych spowodowały – wraz z zadowalającymi wynikami badań klinicznych – częste i z korzyścią dla pacjentów stosowanie escitalopramu w zaburzeniach nastroju (także w tzw. organicznych) i zaburzeniach lękowych, a ostatnio jako leku korygującego zaburzenia zachowania towarzyszące otępieniu, takie jak pobudzenie, agresja czy psychoza. Dodatkowym ważnym aspektem stosowania escitalopramu jest łatwość podawania (jedna dawka na dobę) oraz dostępność postaci w kroplach, która może być szczególnie użyteczna dla chorych z problemami w połykaniu, przyjmujących wiele leków, karmionych poprzez gastrostomię czy z zaburzeniami funkcji poznawczych.
Chłoniak Hodgkina u osób w wieku podeszłym Zaucha, Jan Maciej; Jurczyszyn, Artur; Wojciechowska, Anna ...
Acta haematologica polonica,
April-June 2013, Letnik:
44, Številka:
2
Journal Article
Recenzirano
The paper presents the clinical characteristics and the treatment of the elderly patient diagnosed with Hodgkin's lymphoma (HL). Older patients (>60-year-old) account for approximately 10–20% of ...patients with HL. The differences in the biology of the disease and the prognosis in elderly compared to younger patients were discussed. This applies to more frequent recognition in elderly patients advanced stage of lymphoma, more frequent occurrence of mixed cellularity subtype and high prognostic indicator. Despite improved outcomes in recent decades of HL prognosis of older patients still remains serious. This results from an inferior response to therapy as well as difficulties in maintaining the proper intensity of treatment. There is no recognized recommended chemotherapy regimen for elderly patients. ABVD regimen used most often seems to be too toxic in this group of patients. The paper discussed other alternative chemotherapy regimens used in this group of patients.
From the analysis of chosen writings of St. John Chrysostom results that the Author as pastor and the moralist observes critically the attitude of many representatives of the older generation. At ...these people the external grey hair is not matched by the internal grey, this means the ripe old age and the increasing vital experience develops at them the power of the faith and beautiful and worthy Christian manner of life. Such people in vain await esteem from the younger generation. Older people can gain esteem at young people, if live in the manner morally beautiful. Then they can transfer the young people their own experience and be for them the good example.
Great expectations of chemotherapy have a significant impact on health activities. Patients relay their opinion on their positive self-assessment perceived with psychophysical capacity, clinical ...symptoms of the disease and the quality of medical actions. The expectation analysis of elderly patients who undergo intravenous chemotherapy was the objective of this paper.
Research was performed in 2012. There were 30 patients of age 60 and more included. All patients were treated in Haematology Ward of District Hospital in Kraków. A questionnaire, ECOG scale, and 5 Juczyński tests were used in order to evaluate the psychophysical capacity of patients. The Juczyński tests measure selected psychological resources which influence on the adaptation of an organism to the disease and treatment. These are: optimism (LOT-R), satisfaction from life (SWLS), sense of self effectiveness (GSES), the degree of disease approval (AIS) and emotional control (CECS).
Significant relations between psychophysical capacity and objective effects of treatment and subjective self-assessment of the state of one health were found. Better functioning of patients (measured by ECOG scale) is strictly correlated with good adjustment and acknowledgment of illness limitations (p=0.022). Patients having good sense of self-satisfaction suffer from different ailments less severely (p=0.039) and expect less intensification of bad syndromes in future (p=0.06). On the other hand those who are overcome with fear anticipate more troubles after chemotherapy (p=0.024).
Based on the results of analysis the distribution of patients’ expectations towards their family, medical caregivers and the process of treatment was obtained. The picture of illness dynamics was presented using two categories: objective (medical) and subjective described by patients evaluations of their state of health during treatment.
The research revealed the necessity of analyzing psychophysical functioning of elderly submitted to long treatment.
The majority of patients with acute myeloid leukemia are elderly. The introduction of new more aggressive treatment regimens with allogeneic stem cell transplantation have resulted in improvement in ...clinical outcome of younger AML patients, but analogous improvement in older patients has not been realized. There is evidence that AML in elderly represents a biologically distinct disease that is more aggressive and less responsive to chemotherapy. The important task is to use prognostic factors and predictive modeling to distinguish patients who will benefit from intensive remission-induction approaches and allogeneic transplantation and others who should be managed with less aggressive strategies or novel agents.
Chronic lymphocytic leukemia (CLL) is predominantly a disease of the elderly, with a median age at diagnosis of 70 years. However, the definition of a cut-off point for a patient to be considered ...elderly is an important issue. The majority of epidemiological studies and clinical trials use a cut-off point of 65 or 70 years to select the elderly population for this leukemia, but more than half of the patients who require therapy are older than 70 years of age. Advanced age has consistently been associated with a poor prognosis in patients with CLL, predominantly due to the frequent occurrence of co-morbid conditions. Such concerns may result in a less aggressive therapeutic approach. Performance status, biological age and number, severity of comorbid conditions should be incorporated into decision-making process with regard to intensity of treatment. Elderly and/or comorbid patients with CLL may not tolerate more aggressive approach due to high risk of unacceptable toxicity of purine nucleoside analogs, especially in combination with cyclophosphamide and rituximab. Therefore in this patient population, chlorambucil is still accepted as the first-line treatment and this agent remains the backbone of treatment against which the new protocols should be tested.
The article aims to assess some selected solutions of the Polish government's programme "Solidarity of generations" SG designed to support economic activity among people aged 50+. It presents the ...results of a national survey conducted in the first half of 2012, mainly the outcomes of questionnaire interviews carried out with representative samples of people aged 45+ and employers. Studies under the name "Diagnosis of the current situation of females and males 50+ on the labour market in Poland D50+" were conducted within the project "Equal Opportunities in the Labour Market for People Aged 50+". In addition to standard methods of descriptive analysis and the assessment of relations, factor analysis is also used to identify the main types of activities advancing opportunities for people aged 45+. Some solutions of the government's programme, such as the protection of employees from dismissal during the last four years before their retirement, were sometimes evaluated very differently by employers and people aged 45+. At the same time, both employers and people aged 45+ were favourable about free training and public subsidies to set up jobs for an unemployed persons aged 50+. According to the factor analysis results, the most important activities for people aged 45+ to have equal opportunities in the labour market are those activities that directly improve their qualifications. Although this finding is endorsed by both employers and people aged 45+, the insufficient systemic support for life-long learning limits the number of opportunities they could use to increase their employment activity. The variety of evaluations presented by the beneficiaries of the government programme should be taken into account in planning its modification.
Praise for Generation Blend: Managing Across the Technology Age Gap "There is no more important issue facing today's enterprise than the digital age gap. To avoid a generational clash and exploit the ...power of intergenerational collaboration and knowledge sharing, every organization needs to think differently.
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