Introduction: Although currently less major amputation is performed, due to more effective revascularization and endovascular treatment, limbs amputations are still necessary and commonly used as a ...therapeutic method. Amputation of the lower limb is associated with long-term hospitalization, treatment, rehabilitation and a high level of mortality among older people. For the elderly, additionally suffer from number of chronic diseases, who for various reasons amputation of the limb is the only possible treatment option, recommendations regarding further care after such surgery are important. Results: Causes of lower limb amputation include ia. non-traumatic reasons like diabetes or infection and traumatic ones. Frequency of removal of the lower limb, regardless of its reason is estimated about 5.6 to 600 per 100,000 people and the percentage is about 20 times higher in diabetes-suffering people than in non-diabetic. In the case of this disease, amputations mainly concern men over 60 years of age, as well as people who have been subject to hospital treatment many times. Care for a patient who is prepared to amputation procedure include pre- and post-operative rehabilitation, prosthesis of amputated limb, psychological care, patient education and also pharmacotherapy. It is important to give to patient enoxaparin to reduce thromboembolic risk. To increase quality of life after amputation it is important to provide adequate nursing care. Discussion: Other overlooked diseases, which can lead to lower limb amputation are ia. Charcot disease. Proper diagnosis, differentiation and treatment process is extremely important cause can allow patient to avoid the amputation. Conclusion: Gathered recommendations for correct, high-quality, multi-faceted medical care for patients after amputation of the lower limb will improve the quality of medical services for this group of patients.
Introduction: Although currently less major amputation is performed, due to more effective revascularization and endovascular treatment, limbs amputations are still necessary and commonly used as a ...therapeutic method. Amputation of the lower limb is associated with long-term hospitalization, treatment, rehabilitation and a high level of mortality among older people. For the elderly, additionally suffer from number of chronic diseases, who for various reasons amputation of the limb is the only possible treatment option, recommendations regarding further care after such surgery are important. Results: Causes of lower limb amputation include ia. non-traumatic reasons like diabetes or infection and traumatic ones. Frequency of removal of the lower limb, regardless of its reason is estimated about 5.6 to 600 per 100,000 people and the percentage is about 20 times higher in diabetes-suffering people than in non-diabetic. In the case of this disease, amputations mainly concern men over 60 years of age, as well as people who have been subject to hospital treatment many times. Care for a patient who is prepared to amputation procedure include pre- and post-operative rehabilitation, prosthesis of amputated limb, psychological care, patient education and also pharmacotherapy. It is important to give to patient enoxaparin to reduce thromboembolic risk. To increase quality of life after amputation it is important to provide adequate nursing care. Discussion: Other overlooked diseases, which can lead to lower limb amputation are ia. Charcot disease. Proper diagnosis, differentiation and treatment process is extremely important cause can allow patient to avoid the amputation. Conclusion: Gathered recommendations for correct, high-quality, multi-faceted medical care for patients after amputation of the lower limb will improve the quality of medical services for this group of patients.
Abstract
Background
Direct-acting antiviral (DAA) treatment has revolutionized hepatitis C virus (HCV) care. We aimed to evaluate the risk for the development of hepatocellular carcinoma (HCC) in ...patients aged 75–84 years with chronic hepatitis C after HCV elimination.
Methods
This multicenter cohort study included 2405 consecutive patients with chronic hepatitis C without a history of HCC who achieved HCV elimination by DAAs. Patients in whom HCC developed within 1 year of DAA initiation were excluded. Propensity score matching analysis was used to evaluate differences in HCC risk between patients aged 75–84 versus 60–74 years.
Results
The median observational period was 3.5 years. Among patients aged 75–84 years with a high Fibrosis-4 (FIB-4) index (≥3.25 at baseline), there was no significant difference in the annual incidence of HCCs between groups with an FIB-4 index ≥3.25 (2.75 per 100 person-years PY) versus <3.25 (2.16 per 100 PY) at 12 weeks after the end of treatment, unlike the results in those aged 60–74 years (3.61 and 1.51 per 100 PY, respectively) (adjusted hazard ratio, 2.20; P = .04). In 495 pairs matched by propensity score matching, in patients without cirrhosis, the cumulative HCC incidence was significantly higher in the 75–84-year than in the 60–74-year age group (P = .04).
Conclusions
Older patients aged 75–84 years remained at high risk for the development of HCC, even after HCV elimination and the improvement of the FIB-4 index to <3.25.
This study was performed to elucidate the risk of hepatocellular carcinoma (HCC) after elimination of hepatitis C virus in patients aged ≥75–84 years. Fibrosis biomarker improvement had little positive effect on HCC risk for patients in this age group.
The aim of this study is to collect basic data for the prevention of accidents caused by pedal misapplication among the elderly. We hypothesized that frequent pedal changes in parking lots would ...increase the variance of the foot position on the brake pedal. We install on-dash cams in cars owned by elderly drivers and asked them to drive freely. The results supported the hypothesis. It is possible that this large variance may be a cause of the pedal misapplication.
In the previous study, we developed a risk assessment test using a touch panel display, and attempted to measure self-monitoring ability based on the relationship between actual performance and its ...self-estimation. In this paper, in addition to this, we examined the relationship between the intention to compensate by velocity selection and the actual driving behavior on the road. In this study we increased the number of participants. In addition to this, a certified driving instructor rode along with the participants to evaluate their driving. Actual performance on the risk assessment test was uncorrelated with self-estimation of the test result. The self-estimation of the test result and the velocity considered appropriate for driving the same road again on the test were also uncorrelated. On the other hand, there was a significant correlation between the appropriate velocity selected on the test and the number of times the instructor rated the velocity as inappropriate. An analysis of variance of the two factors, with the adequacy of the self-assessment and the duration of the TMT-B time required as factors, revealed a significant interaction, with the group whose TMT-B time required exceeded 33.4 seconds (Median) and whose self-estimation deviated from the actual performance by more than 10% having significantly lower instructor driving score than the other groups.
The SQ-CCDC, a simplified questionnaire with a variety of driving-related variables, was developed using items that can represent differences among elderly drivers, and it is better to be able to ...provide feedback immediately after answering in order to operationalise it. It is not realistic to estimate the latent rank of respondents from their response patterns using LRT software. It is more practical to be able to estimate the latent rank from the sum score. In this report, we examined the cut-off points so that ranks can be analogously estimated from the sum scores of each subscale.
