• Title/Summary/Keyword: older patients

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Quality of Life of Older Cancer Patients in Comparison with Older Chronic Disease Patients and Middle-Aged Cancer Patients (노인 암환자를 중심으로 노인 만성질환자 및 중년 암환자 간의 삶의 질과 그 영향 요인 비교)

  • Lim, Yeonok;Kim, Yojin;Yoon, Hyunsook
    • Korean Journal of Social Welfare
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    • v.65 no.4
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    • pp.367-393
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    • 2013
  • Quality of life(QoL) of older cancer patients have not gained enough attention from researchers even when cancer is the number one cause of death of Korean elderly. Therefore, this study aims at understanding the QoL of older cancer patients and factors related to it, applying Taylor(2012)'s Stress-Coping Process model, and by comparing with older chronic disease patients and middle-aged cancer patients. Results indicated that physical health QoL of older cancer patients was the worst and their mental health QoL was similar with middle aged cancer patients. Multi-group analysis of Structural Equation Modeling indicated that the relation between QoL and the stress coping resources was not statistically different from older cancer patients and older chronic disease group, as well older cancer patients and middle-aged cancer patients. Implications of results to improve the QoL of older cancer patients are discussed.

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Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years: A Systematic Literature Review and Meta-Analysis

  • Zelalem Chimdesa Merga ;Ji Sung Lee ;Chung-Sik Gong
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.428-450
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    • 2023
  • This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46-7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19-1.56; P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer. The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.

Unique Features of Gastric Cancer in Young Patients: Experience from a General Hospital in Nepal

  • Kandel, Bishnu Prasad;Singh, Yogendra Prasad;Ghimire, Bikal
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2695-2697
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    • 2016
  • Background: Gastric cancer, the fifth most common malignancy in the world, usually affects older individuals but can occur in younger age groups. In this study we compared the clinicopathological profile of young patients of gastric cancer with that of older patients. Materials and Methods: It is a prospective study of gastric cancer patients treated over three year period (January 2012 to December 2014). Data of patients were obtained from the medical record. Clinical and pathological characters of younger patients (age 40 years or less) were compared with older patients (age more than 40 years). Results: There were total of 152 patients treated during the study period. Twenty patients (13.2%) were less than 40 years of age and 132 (86.8%) were older. The male to female ratio in younger patients was 1:1.5 whereas in older patients it was 1:0.6. In the younger age group 14 patients (70%) had poorly differentiated adenocarcinoma in contrast to 45% in the older age group (p<0.01). Some 55% of younger and 42% of older patients had stage IV disease at presentation and curative surgery was not possible. Palliative surgery for gastric outlet obstruction or bleeding from the tumor was performed on 25% and 21% respectively. Conclusions: Gastric cancer in young people aged less than 40 years has unique characters like female predominance, unfavorable tumor biology, and advanced stage at presentation. There should be a high index of suspicion of gastric cancer even in young patients.

Impact of Age on Clinicopathological Features and Survival of Patients with Noncardia Gastric Adenocarcinoma

  • Bautista, Marita C.;Jiang, Sheng-Fang;Armstrong, Mary Anne;Postlethwaite, Debbie;Li, Dan
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.238-245
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    • 2014
  • Purpose: Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors and outcomes from those of older patients remain unclear. Materials and Methods: We identified 1,366 cases of newly diagnosed noncardia gastric adenocarcinoma from the Kaiser Permanente Northern California Cancer Registry between 2000 and 2010. We then compared the clinicopathological features and survival among the different age groups. Results: The male : female ratio differed significantly between the younger and older patient groups (0.84 in age <50 years vs. 1.52>60 years, P<0.01). More younger patients were Hispanic (54% patients <40 years vs. 19% patients ${\geq}70$ years, P<0.0001), while more older patients were Caucasian (49% patients ${\geq}70$ years vs. 15% patients <40 years; P<0.0001). The diffuse/mixed histological type was more prevalent in younger patients (70% patients <40 years vs. 27% patients ${\geq}70$ years; P<0.0001), whereas the intestinal type was more frequent in older patients (71% in patients ${\geq}70$ years vs. 30% in patients <40 years; P<0.0001). Poorly differentiated adenocarcinoma was more common in the younger patients (80% in patients <40 years vs. 60% in patients ${\geq}70$ years; P=0.016). Survival rates at 1, 2, and 5 years gradually declined with increasing age (overall P=0.0002). Conclusions: Young patients with gastric cancer had more aggressive disease but higher overall survival rates than older patients. Younger Hispanic patients and older Caucasian patients were more likely to be diagnosed with gastric cancer. These differences may be due to biological predisposition and/or environmental exposure.

Comparison of Clinical Manifestations and Treatment-Seeking Behavior in Younger and Older Patients with First-time Acute Coronary Syndrome (성인과 노인 관상동맥증후군 초발 환자의 임상적 특성 및 치료추구행위 비교)

  • Hwang, Seon-Young
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.888-898
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    • 2009
  • Purpose: This study was conducted to examine and compare clinical manifestations and predicting factors for treatment-seeking delay among patients <65 and ${\geq}65\;yr$ with first-time acute coronary syndrome (ACS). Methods: A total of 288 patients who were diagnosed with ACS were individually interviewed at C university hospital in G-city from November 2007 to December 2008. Results: Median pre-hospital delays for younger and older patients were 5 and 12 hr, respectively. Younger patients were more likely to be current smokers, heavy drinkers, obese, stressed, and have an unhealthy diet and family history, and to complain of chest pain, left shoulder and arm pain, perspiration, and nausea. Older patients were more likely to have hypertension and diabetes, and to complain syncope and dyspnea. Logistic regression analyses showed that after adjustment for age, gender and education, progressive onset of symptom and no attribution to cardiac problem significantly predicted pre-hospital delay >3 hr in both younger and older patients. Low perceived health status was a significant independent predictor in older patients only. Conclusion: Health care providers should be concerned with different manifestations between younger and older adults, and educate people at risk for heart attack about symptoms and actions to get immediate help.

The Importance of Age as a Factor of Carpal Tunnel Syndrome management (수근관 증후군 치료결정의 한 요인으로 연령의 중요성)

  • Kim, Ja-Young;Park, Hae-Yoon;Kang, Sung-Soo
    • Annals of Clinical Neurophysiology
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    • v.3 no.1
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    • pp.15-20
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    • 2001
  • Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.

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Sleep Disorder Experience in Older Patients with Depression (우울증 노인의 수면장애 경험)

  • Jun, Seong-Sook;Ha, Su-Jung
    • Journal of Korean Academy of Nursing
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    • v.44 no.3
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    • pp.270-279
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    • 2014
  • Purpose: The purpose of this study was to identify sleep disorder experience in older patients living in the community and acknowledging being depressed. Methods: For this study, 11 older patients with depression were purposively chosen. Data were collected through indepth individual interviews from July 2013 to January 2014 and analyzed in terms of by Giorgi's phenomenological methodology. Results: The study results showed that sleep disorder experience in older patients with depression consisted of sixteen themes and five themes-clusters: 1) exposure of the causes of sleep disorders; 2) life is painful; 3) harassing themselves and their family; 4) difficulty in controlling themselves; 5) trying to deal with the sleep disorder to overcome the situation. Conclusion: It is necessary to develop educational guidelines for patients with sleep disorders or nursing interventions that anyone can easily provide for elders in the communities. The first priority should be given to efforts to apply diverse methods to improve sleep hygiene and minimize the period of exposure to medication before starting medication for patients with sleep disorders.

An Analysis of the Difference between Early and Older elderly in Leisure Activities Satisfaction in Geriatric Hospitals (요양병원의 여가활동 만족도에 대한 전·후기 고령자간의 차이 분석)

  • Cho, Duk Young
    • The Korean Journal of Health Service Management
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    • v.12 no.4
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    • pp.43-57
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    • 2018
  • Objectives: This study analyzes whether the leisure activities satisfaction of elderly and older elderly patients differs with population sociology characteristics for the leisure activities services provided by geriatric hospitals, and to provide basic information to make reasonable decisions. Methods: Difference Analysis of the difference (T-test, ANOVA) in leisure activities satisfaction was conducted for the elderly and older elderly patients hospitalized in nine hospitals. Results: First, In the planning stage of leisure activity program, it is necessary to consider the tendency of men and women to prefer gender-based leisure activity service. Second, It was found that old elderly patients were more in number than elderly patients. Third, managers of geriatric hospitals in Busan and Kyungnam area should consider the needs of the patients in the planning and implementation of leisure activities and improve their leisure activity programs or develop more programs for better customer satisfaction.

Prostate Cancer in Younger and Older Patients: Do We Treat Them Differently?

  • Situmorang, Gerhard Reinaldi;Umbas, Rainy;Mochtar, Chaidir A.;Santoso, Rachmat Budi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4577-4580
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    • 2012
  • Diagnostic and therapeutic strategies of prostate cancer may largely influenced by patients' age at presentation. This study is aimed to evaluate the characteristics, diagnostic and treatment strategies in prostate cancer patients in our centres. A cross-sectional analytic study of prostate cancer data in two main referral cancer centres, Cipto Mangunkusumo General Hospital and Dharmais National Cancer Centre from 1995-2010, was therefore performed. Patients were divided into 2 sub-populations; below 60 years (younger patients) and 75 years old and above (older patients). PSA levels, diagnostic modalities, Gleason score and therapeutic options were analysed for both and compared using bivariate analysis. 152 patients were <60 years and 210 were ${\geq}75$ years. There was no statistical difference in mean PSA level (797.9ng/mL vs 345.3 ng/mL, respectively; p>0.05) and diagnosis was made by biopsy in majority of patients in both groups (68.2% and 71.6% in younger and older groups respectively). Most presented with an advanced disease stage (65.1% and 66.0%, respectively) and there was no statistically significant difference in mean Gleason scores f (8.1 vs 7.7; p>0.05). Primary androgen deprivation therapy (PADT) was the main treatment for overall patients (48.0% and 50.7%, respectively). Radiotherapy and radical prostatectomy are the main therapeutic modalities for younger patients with local and locally advanced disease (39.6% and 35.4% respectively), while the majority of older patients with the same disease stage were treated with radiotherapy and PADT (45.8% and 39.0% respectively). Differences observed in treatment modalities were statistically significant (p<0.0003). We conclude that there is no difference in disease clinical aggressiveness of the two groups but significant differences were observed in therapeutic strategies utilised with younger and older patients.

Simple Radiographic Analysis of Chronic Shoulder Pain in Patients 50 Years and Older (만성 견관절 동통을 가진 50세 이상 환자의 단순 방사선 사진 분석)

  • Yoo Chong II;Kim Hui Taek;Eun II Soo
    • Clinics in Shoulder and Elbow
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    • v.7 no.1
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    • pp.14-22
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    • 2004
  • Purpose: To evaluate a usefulness of the simple radiograph in the patients with chronic shoulder pain 50 years and older. Material and method: 1152 patients with chronic shoulder pain and 100 asymptomatic individuals were involved in this study. All patients were 50 years and older. We excluded patients who had a history of fracture or dislocation. Radiographic interpretation was performed on a shoulder AP view, an axillary view and a supraspinatus outlet view. For statistical analysis, a chi-square test was performed. A p value of <0.05 was considered statistically significant. Results: Abnormal radiologic findings were identified in 369(32%) out of 1152 patients with a shoulder pain: greater tuberosity sclerosis, acromial sclerosis, subacromial osteophytes are common abnormal radiologic findings. A rotator cuff tear or impingement syndrome was identified on a final diagnosis in 61(85.2%) out of the 76 patients with radiologic abnormalities in both greater tuberosity and acromion (p<0.05). Abnormal radiologic findings were identified in 18% of the asymptomatic individuals. Conclusion: Simple radiographic analysis is an important primary diagnostic tool in patients (50 years and old) with chronic shoulder pain.