Associated Factors for Falls among the Community-Dwelling Older People Assessed by Annual Geriatric Health Examinations

BACKGROUND: Falls are very common among the older people. Nearly one-third older people living in a community fall each year. However, few studies have examined factors associated with falls in a community-dwelling population of older Taiwanese adults. OBJECTIVES: To identify the associated factors for falls during the previous 12 months among the community-dwelling Taiwanese older people receiving annual geriatric health examinations. PARTICIPANTS: People aged sixty-five years or older, living in the community, assessed by annual geriatric health examinations METHODS: 1377 community-dwellers aged ≥65 years who received annual geriatric health examinations at one hospital in northern Taiwan between March and November of 2008. They were asked about their history of falls during the year prior to their most recent health examination. RESULTS: The average age of the 1377 participants was 74.9±6.8 years, 48.9% of which were women. Three-hundred and thirteen of the participants (22.7%) had at least one fall during the previous year. Multivariate analysis showed that odds ratio for the risk of falling was 1.94 (95% CI 1.36-2.76) when the female gender group is compared with the male gender group. The adjusted odds ratios of age and waist circumference were 1.03 (95% CI 1.00-1.06) and 1.03 (95% CI 1.01-1.05) respectively. The adjusted odds ratios of visual acuity, Karnofsky scale, and serum albumin level were 0.34 (95% CI 0.15-0.76), 0.94 (95% CI 0.89-0.98), and 0.37 (95% CI 0.18-0.76) respectively. Larger waist circumference, older age, female gender, poorer visual acuity, lower score on the Karnofsky Performance Scale, and lower serum albumin level were the independent associated factors for falls. CONCLUSION: In addition to other associated factors, waist circumference should be included as a novel risk factor for falls

Problems in the studies of Zhou oracle-bone scripts

This thesis focuses on three areas of problems in the studies of Zhouyuan oracle-bone inscriptions: the interpretations of inscriptions, identities of kings and the origins of four pieces of Zhouyuan oracle bones. Why these three are chosen is that in order to read the inscriptions correctly, we first have to understand the meanings of words. If the word "king" appears in the inscriptions, it is ideal that we know the time period to which these oracle bones belong, so the information from the inscriptions can be used correctly from historical perspective. The origins of four Zhouyuan oracle bones are discussed because the identities of the kings mentioned are important; if they were Shang kings, they were from the Shang; otherwise, from the Zhou, though other possibilities are not excluded. In Chapter One I give a general introduction to the features of the Zhou oracle bones and inscriptions, so the readers will have background information for the remainder of the thesis. The readers will see some of the problems facing the scholars of the oracle-bone studies. In Chapter Two I attempt to determine who the kings were on fourteen pieces of Zhou oracle bone, so that these oracle bones, as historical artifacts, can be periodized properly; also in Chapter Two, I provide interpretations on the functions and meanings of the words that some of the characters represent on these fourteen pieces, in order that the inscriptions can be fully understood. In Chapter Three, I seek to ascertain the origins of four pieces of Zhou oracle bones which have caused controversy: by identifying who the kings were on these four pieces, we will thus be able see whether they belonged to the Shang or the Zhou. Chapter Four is the conclusion of this thesis. Appendix One details the discoveries of Zhou oracle bones in various locations in China through the years. Appendix Two is my response to K. Takashima's recent article on the modal and aspectual particle qi ^ and whether it is applicable to the use of qi in the Zhou oracle-bone inscriptions. I conclude that his theory is generally applicable: qi functions as a modal and an aspectual particle; it also indicates that the diviners wanted, for the most part, the contemplated charges to be acceptable to the spirits.Arts, Faculty ofAsian Studies, Department ofGraduat

Diagnostic Significance of Intracystic Nodules on MRI in Rathke’s Cleft Cyst

Background and Purpose. To explore strategies for the diagnosis and treatment of Rathke’s cleft cyst (RCC). Methods. The medical records of 24 patients with sellar RCC were retrospectively reviewed. Two patients had concomitant pituitary adenoma, 2 underwent transcranial surgery, and 22 underwent transsphenoidal surgery. The clinical features, especially the findings of intracystic nodules on MRI, were evaluated and compared with the pathological findings. Results. Preoperatively, only 2 patients were diagnosed with RCC or suspected RCC. Pre- and postoperative MRI images revealed 10 intracystic nodules in 9 (37.5%) patients. Two nodules had bull's eyelike changes. The signal intensity of the intracystic nodules varied on T1- and T2-weighted images. Not all nodules on T2-weighted images were visualized. Postoperative MRI revealed recurrence or residual lesion in 5 patients; none had new symptoms and a second surgery was not required. Conclusions. Identifying intracystic nodules is important in patients with sellar cystic lesions. Bull’s eyelike change in an intracystic nodule on MRI, which is reported here for the first time, potentially might have value for confirming the diagnosis

Safety of Nonagenarians Receiving Therapeutic ERCP, Single Center Experience

(1) Background: The complication rates for nonagenarians receiving therapeutic endoscopic retrograde cholangiopancreatography (ERCP) remain poorly understood. We aimed to determine whether nonagenarians were at an increased risk of ERCP-related complications. (2) Methods: We performed a retrospective study on therapeutic ERCP in nonagenarians from 2011 to 2016 at Taichung Veterans General Hospital. A control group comprising patients aged 65 to 89 years was used to compare demographic data and the outcomes of therapeutic ERCP with the nonagenarians. The risk factors for complications were determined by logistic regression model. (3) Results: There were 35 nonagenarians and 111 patients in the control group. Overall, complication rates were not statistically different between the two groups. However, advanced age was an independent predictor of complications in the multivariate analysis (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.01–1.12; p = 0.049). End stage renal disease (ESRD) was another independent predictor of complications (OR = 4.87; 95% CI = 1.11–21.36; p = 0.036). Post-ERCP pancreatitis and bleeding were more common in ESRD patients than patients without ESRD. (4) Conclusions: Although nonagenarians receiving ERCP did not have more complications compared to elderly patients younger than 90 years, advanced age and comorbidity still affect the outcome of therapeutic ERCP in the elderly patients

Characteristics of faller and non-faller (n = 1377).

<p>Data expressed as mean±SD for continuous variables in normal distribution.</p><p>Mean [median value] for continuous variables not in normal distribution.</p><p>All statistical tests were two-tailed, and a significance level of p = 0.05 or less was used.</p><p>SPMSQ, the Short Portable Mental Status Questionnaire; BSRS-5, the 5-item Brief Symptom Rating Scale; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; BUN, blood urea nitrogen.</p

Multivariate logistic regression analyses of associated factors for falls.

<p>All statistical tests were two-tailed, and a significance level of p = 0.05 or less was used.</p