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An Interview with Dr. Ines Testoni Ines Testoni博士访谈录
Pub Date : 2023-06-27 DOI: 10.21926/obm.geriatr.2302241
Obm Geriatrics Editorial Office
InterviewAn Interview with Dr. Ines TestoniOBM Geriatrics Editorial OfficeLIDSEN Publishing Inc., 2000 Auburn Drive, One Chagrin Highlands, Suite 200, Beachwood, OH, USA; E-Mail: geriatrics@lidsen.comOBM Geriatrics 2023, volume 7, issue 2 doi:10.21926/obm.geriatr.2302241Received: June 25, 2023Accepted: June 26, 2023Published: June 27, 2023
美国俄亥俄州比奇伍德市,2000 Auburn Drive, One Chagrin Highlands, Suite 200;E-Mail: geriatrics@lidsen.comOBM老年病学2023,第7卷,第2期doi:10.21926/obm.geriatr。收稿日期:2023年6月25日收稿日期:2023年6月26日发表日期:2023年6月27日
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引用次数: 0
Polymyalgia Rheumatica Evolved into RS3PE Syndrome. What is the Culprit: Idiopathic or Secondary, Following mRNA-Based COVID-19 Vaccines? A Case Report and Brief Review of the Literature 类风湿性多肌痛演变为RS3PE综合征。什么是特发性或继发性,基于mRNA的新冠肺炎疫苗?病例报告及文献综述
Pub Date : 2023-06-27 DOI: 10.21926/obm.geriatr.2302240
M. Turrin, L. Fornasiero, Antonio Navarro
We describe the clinical case of a 74-year-old male patient who received the second Comirnaty/Pfizer anti-COVID-19 vaccine dose. After 3 weeks he showed the clinical signs of polymyalgia rheumatica. The history included mild chronic normocytic normochromic anemia and hypogammaglobulinemia, osteoarthritis disease, livedo reticularis, hypercholesterolemia, and arterial hypertension. Despite prolonged treatment with NSAIDs and dexamethasone, the disease evolved into remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Neoplastic diseases and associated collagen diseases were excluded. The clinical picture recurred, soon after, the booster dose of the Spikevax/Moderna vaccine. The inflammatory indices were high, the radiographs of the hands were free of erosions, the ultrasound investigations revealed bursitis of the shoulders, knee synovitis, marked subcutaneous edema of the lower limbs, hydrocele, bilateral Baker's cyst in the popliteal cavity, hematoma of a calf. The clinical picture, markedly improved, with oral prednisolone and was stabilized with the association of hydroxychloroquine. The finding of persistent hypomagnesemia was related to chronic intake of esomeprazole. The reports of rheumatological reactions in international databases and the rare cases of RS3PE syndrome following the COVID-19 vaccine described in the literature are considered.
我们描述了一名74岁男性患者的临床病例,该患者接受了第二剂comarnaty /Pfizer抗covid -19疫苗。3周后出现风湿病多肌痛的临床症状。病史包括轻度慢性正红细胞、正色贫血和低γ球蛋白血症、骨关节炎、网状脂肪肝、高胆固醇血症和动脉高血压。尽管长期使用非甾体抗炎药和地塞米松治疗,该疾病仍演变为缓解性血清阴性对称滑膜炎伴凹陷性水肿(RS3PE)综合征。排除肿瘤疾病及相关胶原蛋白疾病。在注射Spikevax/Moderna疫苗加强剂后不久,临床症状再次出现。炎症指数高,手部x线片无糜烂,超声检查显示肩部滑囊炎,膝关节滑膜炎,下肢明显皮下水肿,鞘膜积液,双侧腘窝腔贝克氏囊肿,小腿血肿。口服强的松龙后,临床表现明显改善,并与羟氯喹联合稳定。发现持续性低镁血症与长期摄入埃索美拉唑有关。我们考虑了国际数据库中风湿病反应的报告以及文献中描述的COVID-19疫苗后RS3PE综合征的罕见病例。
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引用次数: 0
Role of Activity Professionals in Applying APIE Model to Enhance Residents’ Activity and Engagement in Long-Term Care Settings 活动专业人员在应用APIE模式以提高长期护理环境中居民的活动和参与方面的作用
Pub Date : 2023-06-25 DOI: 10.21926/obm.geriatr.2302239
Xiaoli Li, Kendall Brune, Jean Keller, Jennifer Stelter, S. Ingman
Residents’ activity is a strong contributor to the quality of life in long-term care facilities. Hence, activity professionals have an essential role to play in enhancing residents’ activity engagement. Professional practice model for activity professionals includes Assessment, Planning, Implementation, and Evaluation (APIE model). Although activity professionals have made advances in demonstrating their value, few studies have focused on the APIE model for activity professionals in long-term care facilities. A survey was conducted to help understand the role of activity professionals in using APIE in long-term care. Questionnaires were completed by 195 activity professionals working as activity directors and activity staff in long-term care settings. The major factors studied were job background, certification, and the performance of activity professionals using the APIE model. Findings showed that 11.8% of the activity professionals had a high school education, 12.3% had no certification, and 9.2% of them had unrelated certifications. When examining the APIE model, we found that activity professionals used person-centered approaches when they assessed residents` needs and wants, planned and implemented the activities, but lacked evaluation when measuring the outcomes; 79.5% of the participants were not tracking the number of minutes residents spent on activities; and 72.8% of the respondents did not measure the impact of resident engagement on clinical outcomes such as falls, depression, cognition, and medication use. Lack of professional training and the application meaningful evaluation related to the impact of activities with residents by activity professionals may challenge administrators’ capacity of estimating the need, value, and role of activity professionals within long-term care facilities. The study advocates for applying the APIE process to the delivery of activities and evaluation of the benefits of residents` activity and engagement.
居民的活动对长期护理机构的生活质量有很大贡献。因此,活动专业人员在提高居民的活动参与度方面发挥着至关重要的作用。活动专业人员的专业实践模式包括评估、规划、实施和评估(APIE模式)。尽管活动专业人员在展示其价值方面取得了进展,但很少有研究关注长期护理机构活动专业人员的APIE模型。进行了一项调查,以帮助了解活动专业人员在长期护理中使用APIE的作用。问卷由195名在长期护理环境中担任活动主管和活动工作人员的活动专业人员完成。研究的主要因素是工作背景、证书和使用APIE模型的活动专业人员的表现。调查结果显示,11.8%的活动专业人员受过高中教育,12.3%没有证书,其中9.2%有无关证书。在研究APIE模型时,我们发现活动专业人员在评估居民的需求和愿望、计划和实施活动时使用了以人为中心的方法,但在衡量结果时缺乏评估;79.5%的参与者没有跟踪居民在活动上花费的分钟数;72.8%的受访者没有衡量居民参与对跌倒、抑郁、认知和药物使用等临床结果的影响。活动专业人员缺乏与居民活动影响相关的专业培训和有意义的应用评估,可能会挑战管理人员估计长期护理机构中活动专业人员的需求、价值和作用的能力。该研究主张将APIE流程应用于活动的开展以及对居民活动和参与的效益的评估。
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引用次数: 0
The Geriatric Impact in the Management of Complex Cancer Patients: A Monocenter Experience 老年对复杂癌症患者管理的影响:单中心经验
Pub Date : 2023-06-13 DOI: 10.21926/obm.geriatr.2302238
A. Bellieni, Beatrice Di Capua, E. Villani, L. Tagliaferri, D. Fusco, M. Gambacorta, Francesco Presta, S. Bracci, V. Valentini, F. Landi, G. Colloca
New technologies, aging-related changes, and evolution in patients' needs have led to a new scenario in all oncological fields in front of which we have to move on. Technological progress has made it possible to increase the number of patients treated, including elderly patients and generally those at higher risk of toxicity. However, this scenario has led to new problems requiring new skills to be addressed. For this reason, Gemelli-ART (Advanced Radiation Therapy) of Fondazione Policlinico Universitario A. Gemelli IRCCS – Rome, Italy, started a collaboration with a team of geriatricians trained in geriatric oncology to manage the growing number of elderly patients and to deal with treatment-related toxicity and supportive care to complete planned treatment. This study evaluates the impact of geriatric oncology intervention performed by a geriatrician with particular expertise in managing complex cancer patients admitted to an Oncology Unit. The number of complex patients admitted to the Radiation Oncology Unit raised from 90 in 2016 to 226 in 2018 (+151.1%). 63.4% of complex patients underwent treatment, with a curative goal in 43.7% of cases. Among all admitted patients, the treatment discontinuation rate was 14%. The treatment discontinuation rate was 5.5% in patients over 80 years old with planned admission, versus 27.0% in patients admitted from the emergency room. Our data suggest that geriatric expertise in an Oncology Unit helps personalize patients' treatment and allows for treating an increasing number of complex patients. Identifying frail and complex patients is essential to manage these situations effectively and efficiently, optimize healthcare resources, avoid over and under-treatment, and provide the best care.
新技术、与老龄化相关的变化以及患者需求的演变导致了所有肿瘤领域的新情况,我们必须在此之前继续前进。技术进步使治疗的患者人数增加成为可能,包括老年患者和一般毒性风险较高的患者。然而,这种情况导致了需要解决新技能的新问题。出于这个原因,意大利罗马基金会政治大学a . Gemelli IRCCS的Gemelli- art(高级放射治疗)开始与一个接受过老年肿瘤学培训的老年病专家团队合作,以管理越来越多的老年患者,并处理与治疗相关的毒性和支持护理,以完成计划治疗。本研究评估了由一名在管理肿瘤部门收治的复杂癌症患者方面具有特殊专业知识的老年病专家进行的老年肿瘤干预的影响。放射肿瘤科复杂患者从2016年的90例增加到2018年的226例(+151.1%)。63.4%的复杂患者接受了治疗,43.7%的患者达到了治愈目标。在所有住院患者中,停药率为14%。80岁以上计划住院的患者停药率为5.5%,而从急诊室入院的患者停药率为27.0%。我们的数据表明,肿瘤科的老年医学专业知识有助于个性化患者的治疗,并允许治疗越来越多的复杂患者。识别体弱和复杂的患者对于有效和高效地管理这些情况、优化医疗保健资源、避免过度治疗和治疗不足以及提供最佳护理至关重要。
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引用次数: 0
The Global Malnutrition Composite Score Quality Measure-Seize this Opportunity to Benefit Older Adult Care and Health Equity! 全球营养不良综合评分质量测量——抓住这个机会,促进老年人护理和卫生公平!
Pub Date : 2023-05-25 DOI: 10.21926/obm.geriatr.2302237
P. Brown, Dana Buelsing Sowards, M. Pittman, Gisele Leger, Susan Manns
In August 2022, the Centers for Medicare and Medicaid Services (CMS) adopted its first-ever nutrition electronic clinical quality measure (eCQM), known as the Global Malnutrition Composite Score (GMCS) as part of the Inpatient Hospital Quality Reporting (IQR) Program. Starting in January 2024, hospitals can self-select to include the GMCS as one of three optional eCQMs for reporting. This article focuses on the importance of addressing malnutrition to improve the overall health of the aging population, reduce preventable healthcare expenditures and achieve greater health equity. A detailed explanation of the development of the GMCS, its components, its utility, and the critical role of registered dietitian nutritionists (RDNs) in promoting its adoption are discussed. The successful implementation of malnutrition quality measures and their positive impact on patient care and business operations is exemplified through the experience of the Novant Health New Hanover Regional Medical Center of Southeastern North Carolina. A recommended process for RDNs to pursue to secure the adoption of the GMCS at their respective hospitals and supporting resources are reviewed.
2022年8月,医疗保险和医疗补助服务中心(CMS)通过了其首个营养电子临床质量测量(eCQM),即全球营养不良综合评分(GMCS),作为住院医院质量报告(IQR)计划的一部分。从2024年1月开始,医院可以自行选择将GMCS作为三个可选eCQM之一进行报告。本文重点阐述了解决营养不良问题对改善老龄人口整体健康、减少可预防的医疗支出和实现更大的健康公平的重要性。详细解释了GMCS的发展、成分、用途,以及注册营养师在促进其采用方面的关键作用。营养不良质量措施的成功实施及其对患者护理和商业运营的积极影响体现在北卡罗来纳州东南部Novant Health New Hanover地区医疗中心的经验中。审查了RDN为确保在各自医院采用GMCS而采取的建议流程和支持资源。
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引用次数: 0
The Effects of Loneliness on the Aged: A Review 孤独对老年人的影响:综述
Pub Date : 2023-05-17 DOI: 10.21926/obm.geriatr.2302236
A. Rokach
Social support has been shown to have many positive effects on our lives, health, and ability to grow and flourish. Lack, or diminished social support results in loneliness. This thematic review focuses on the elderly, and the loneliness that is part of the life of many of them. The review highlights the social connections and the expectations that the elderly may have of them, and how being connected to others may alleviate, loneliness. Loneliness is known to negatively affect one’s health, social life, familial relationships, and feelings, and their effect on the elderly is described. We all yearn for social support, and the review examines what are the elderly’s expectations from their social support network. Expectations which will significantly affect their commitment to that network, and feeling fulfilled by it. The review concludes with a focus on successful aging and how they can control and minimize their loneliness and feelings of isolation.
社会支持已被证明对我们的生活、健康以及成长和繁荣的能力有许多积极影响。缺乏或减少社会支持会导致孤独。这篇主题综述聚焦于老年人,以及他们中许多人生活中的孤独。这篇综述强调了老年人的社会联系和对他们的期望,以及与他人的联系如何缓解孤独感。众所周知,孤独会对一个人的健康、社会生活、家庭关系和感情产生负面影响,并对其对老年人的影响进行了描述。我们都渴望社会支持,这项审查考察了老年人对其社会支持网络的期望。期望会显著影响他们对网络的承诺,以及对网络的满足感。该综述最后重点关注成功的衰老,以及他们如何控制和尽量减少孤独感和孤独感。
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引用次数: 0
Older People and the Construction of Virtual Identities in the Digital Culture 老年人与数字文化中的虚拟身份建构
Pub Date : 2023-05-10 DOI: 10.21926/obm.geriatr.2302235
Ondřej Roubal
This research study addresses certain theoretical issues surrounding the relationship between digital technologies, the aging population, and identity. At the same time, it offers a conceptual proposal of indicators of the social inclusion of older people in the digital culture of society as a potential starting point for further empirical research. The progressive trend of a growing proportion of older people is a demographic reality in many economically and technologically advanced societies. This demographic aging of populations raises several economic, sociopolitical, medical, cultural, social, and psychological issues. One of the most important and oft-overlooked sets of issues is the active participation of older people in the digital culture environment and the use of information and communication technologies as an alternative source of social interaction in constructing and affirming their own identity. Aging is often associated with a natural decline in professional activity, poorer health, reduced physical activity, reduced social contacts, and sometimes isolation and loneliness. The active participation of older people in the digital environment of communication and virtual interactions can buffer these negative factors to a certain extent and offer an adequate alternative for fulfilling the need for social relationships, self-actualization, and affirmation of identity. Of course, digital culture does have an ambivalent character. On the one hand, there are obvious positive effects on social life, subjective experience, and consciousness of one's own identity derived from real and virtual social interactions. On the other hand, digitalizing life generates unseen risks in invading an accelerated pace of life, superficiality, and the deepening of social inequalities.
本研究围绕数字技术、人口老龄化和身份之间的关系,探讨了一些理论问题。同时,提出了老年人在社会数字文化中的社会包容指标的概念性建议,作为进一步实证研究的潜在起点。在许多经济和技术先进的社会中,老年人比例不断增加的趋势是一个人口现实。人口老龄化引发了一些经济、社会政治、医疗、文化、社会和心理问题。老年人积极参与数字文化环境,并利用信息和通信技术作为构建和肯定自身身份的社会互动的另一种来源,这是最重要且经常被忽视的一系列问题之一。衰老通常伴随着职业活动的自然减少、健康状况变差、体育活动减少、社会接触减少,有时还伴随着孤立和孤独。老年人积极参与数字交流和虚拟互动的环境,可以在一定程度上缓冲这些负面因素,为满足社会关系、自我实现和身份肯定的需求提供了充分的选择。当然,数字文化确实具有矛盾的特征。一方面,现实和虚拟的社会互动对社会生活、主观体验和自我身份意识产生了明显的积极影响。另一方面,数字化生活也带来了看不见的风险,它加快了生活节奏,使生活肤浅化,加剧了社会不平等。
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引用次数: 0
Emerging Roles of Signal Transduction Pathways in Neurodegenerative Diseases. Hunting New Possible Therapeutic Molecular Targets 信号转导通路在神经退行性疾病中的新作用。寻找新的可能的治疗分子靶点
Pub Date : 2023-05-05 DOI: 10.21926/obm.geriatr.2302234
V. L. Lo Vasco
Illnesses following the degeneration of the nervous system can occur due to aging or genetic mutations and represent a clinical concern. In neurodegenerative diseases, loss of neuronal structure and functions mainly causes cognitive impairment, representing an increasing social burden. In neurodegenerative diseases, the progressive loss of vulnerable populations of neurons in specific regions of the central nervous system was traced to different pathological events, such as misfolded proteins’ accumulation, abnormalities in proteasomes or phagosomes, as well as anomalies in lysosomes or mitochondria. Many research efforts identified important events involved in neurodegeneration, but the complex pathogenesis of neurodegenerative diseases is far from being fully elucidated. More recently, insights into the signal transduction pathways acting in the nervous system contributed to unveiling some molecular mechanisms triggering neurodegeneration. Abnormalities in the intra- or inter-cellular signaling were described to be involved in the pathogenesis of neurodegenerative disease. Understanding the signal transduction pathways that impact the nervous system homeostasis can offer a wide panel of potential targets for modulating therapeutic approaches. The present review will discuss the main signal transduction pathways involved in neurodegenerative disorders.
神经系统退化后的疾病可能是由于衰老或基因突变引起的,这是一个临床问题。在神经退行性疾病中,神经元结构和功能的丧失主要导致认知障碍,代表着越来越大的社会负担。在神经退行性疾病中,中枢神经系统特定区域脆弱神经元群体的逐渐丧失可追溯到不同的病理事件,如错误折叠的蛋白质积累、蛋白酶体或吞噬体异常以及溶酶体或线粒体异常。许多研究工作确定了与神经退行性变有关的重要事件,但神经退行性疾病的复杂发病机制远未完全阐明。最近,对神经系统中作用的信号转导途径的深入了解有助于揭示触发神经退行性变的一些分子机制。细胞内或细胞间信号传导的异常被描述为与神经退行性疾病的发病机制有关。了解影响神经系统稳态的信号转导途径可以为调节治疗方法提供广泛的潜在靶点。本综述将讨论神经退行性疾病的主要信号转导途径。
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引用次数: 0
Use of Artificial Intelligence in Skin Aging 人工智能在皮肤老化中的应用
Pub Date : 2023-04-17 DOI: 10.21926/obm.geriatr.2302233
Minh Chung, V. Jiminez, Mohammad Saleem, N. Yusuf
Skin aging is a complex process that involves several extrinsic and intrinsic factors and skin health is an indicator of the well-being of an individual. In recent years, there have been numerous developments using computerized systems to aid in finding solutions and treatments to skin aging processes. Tools like artificial intelligence (AI) can aid in finding solutions and treatments for skin aging. AI can also help in monitoring or identifying early signs of skin aging. Within the field of skin aging, several innovations utilize AI to provide better patient care. There is a gap in knowledge within this field concerning current and future directions concerning skin aging and AI. In this review, we aim to highlight current and prospective applications of AI in skin aging and provide insights into future modalities in this field. Models for AI can serve to increase patient participation in skin-care decisions and eventually enhance the patient-provider experience.
皮肤老化是一个复杂的过程,涉及几个外在和内在因素,皮肤健康是个人健康的指标。近年来,已经有许多使用计算机系统来帮助寻找皮肤老化过程的解决方案和治疗方法的发展。人工智能(AI)等工具可以帮助寻找皮肤衰老的解决方案和治疗方法。人工智能还可以帮助监测或识别皮肤衰老的早期迹象。在皮肤老化领域,一些创新利用人工智能提供更好的患者护理。关于皮肤衰老和人工智能的当前和未来方向,该领域的知识存在差距。在这篇综述中,我们旨在强调人工智能在皮肤衰老中的当前和潜在应用,并对该领域的未来模式提供见解。人工智能模型可以提高患者对皮肤护理决策的参与度,并最终增强患者提供者的体验。
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引用次数: 0
Driving Safety in Healthy Aging and Age-Related Diseases 健康老龄化和年龄相关疾病中的驾驶安全
Pub Date : 2023-04-04 DOI: 10.21926/obm.geriatr.2302232
M. Falkenstein, Ute Brüne-Cohrs
EditorialDriving Safety in Healthy Aging and Age-Related DiseasesMichael Falkenstein *, Ute Brüne-CohrsALA Institute, 44805 Bochum, Germany; E-Mails: falkenstein@ala-institut.de; Ute.Bruene-Cohrs@ruhr-uni-bochum.de * Correspondence: Michael Falkenstein; E-Mail: falkenstein@ala-institut.deSpecial Issue: Driving Safety in Healthy Aging and Age-Related DiseasesOBM Geriatrics 2023, volume 7, issue 2 doi:10.21926/obm.geriatr.2302232Received: April 03, 2023Accepted: April 03, 2023Published: April 04, 2023
《健康老龄化和年龄相关疾病中的驾驶安全》,Michael Falkenstein*,Ute Brüne CohrsALA研究所,44805,德国波鸿;电子邮件:falkenstein@ala-institut.de;Ute.Bruene-Cohrs@ruhr-uni-bochum.de*通讯:Michael Falkenstein;电子邮件:falkenstein@ala-institut.deSpecial问题:健康老龄化和年龄相关疾病中的驾驶安全BM老年医学2023,第7卷,第2期doi:10.21926/obm.geriatr.232232收到日期:2023年4月3日接受日期:2024月3日电发布日期:2025年4月4日
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引用次数: 0
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OBM geriatrics
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