43 research outputs found
Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients
Background
As the world population ages, the number of hip-related fractures in the elderly is steadily increasing. These fractures generate a major worldwide healthcare problem and frequently lead to deterioration of life quality, mobility and independence in activity of daily life of geriatric patients. At present, many studies have investigated and proved benefits of multidisciplinary orthogeriatric care for elderly hip-fracture patients. Only few studies however, have analyzed treatment concepts for those patients directly following discharge from hospital in specialized rehabilitation centers. The aim of this study was to evaluate effects of a multidisciplinary inpatient rehabilitation on the short- and long-term functional status of geriatric patients who suffered from hip fracture.
Methods
A total of 161 hip-fracture patients aged 80 years and above, or additionally 70 years and above suffering from age-typical multimorbidity were included in this study. Patients who had an initial Barthel Index lower than 30 points were excluded from this study, as most of these patients were not able to attend a therapy at the rehabilitation center due to a poor functional status. The patients were separated into two subgroups dependent on the availability of treatment spots at the rehabilitation center. No other item was used to discriminate between the groups. Group A (n = 95) stayed an average of 21 days at an inpatient rehabilitation center that specialized in geriatric patients. Group B (n = 66) underwent the standard postoperative treatment and were sent home with further treatment by their general practitioner, nursing staff and physiotherapists. To evaluate the patients’ functional status over the course of time we used the Barthel Index, which was evaluated for every patient on the day of discharge, as well as during checkups after 3, 6 and 12 months.
Results
The average Barthel Index at the day of discharge was 57.79 ± 14.92 points for Group A and 56.82 ± 18.76 points for Group B (p = 0.431). After 3 months, the average Barthel Index was 82.43 points for Group A and 73.11 points for group B (p = 0.005). In the 6-month checkup Group A’s average Barthel Index was 83.95 points and Group B’s was 74.02 points (p = 0.002). After 12 months, patients from Group A had an average Barthel Index of 81.21 while patients from Group B had an average Barthel Index of 69.85 (p = 0.005).
Conclusion
The results of this study reveal a significantly better outcome concerning both, short-term and long-term functional status after 3, 6 and 12 months for geriatric hip-fracture patients, who underwent an inpatient treatment in a rehabilitation center following the initial therapy
Acyl Chain-Dependent Effect of Lysophosphatidylcholine on Endothelium-Dependent Vasorelaxation
Peer reviewe
Transkulturelle Erkundungen:wissenschaftliche-künstlerische Perspektiven
Dieses Werk präsentiert interdisziplinäre und internationale Zugänge zur Transkulturalität aus Philosophie, Politikwissenschaft, Ethnomusikologie, Popularmusikforschung, Gender und Queer-Studies, Musikwissenschaft, Musikpädagogik, Postcolonial Studies, Migrationsforschung und Minderheitenforschung. Es sind die nachhaltigen Ergebnisse einer Ringvorlesung an der Universität für Musik und darstellende Kunst Wien-mdw aus den Jahren 2014-2018, bei der Wissenschaft und Kunst in einen fruchtbaren Dialog traten
The SISAL database: a global resource to document oxygen and carbon isotope records from speleothems
Stable isotope records from speleothems provide information on past climate changes, most particularly information that can be used to reconstruct past changes in precipitation and atmospheric circulation. These records are increasingly being used to provide “out-of-sample” evaluations of isotope-enabled climate models. SISAL (Speleothem Isotope Synthesis and Analysis) is an international working group of the Past Global Changes (PAGES) project. The working group aims to provide a comprehensive compilation of speleothem isotope records for climate reconstruction and model evaluation. The SISAL database contains data for individual speleothems, grouped by cave system. Stable isotopes of oxygen and carbon (δ 18O, δ 13C) measurements are referenced by distance from the top or bottom of the speleothem. Additional tables provide information on dating, including information on the dates used to construct the original age model and sufficient information to assess the quality of each data set and to erect a standardized chronology across different speleothems. The metadata table provides location information, information on the full range of measurements carried out on each speleothem and information on the cave system that is relevant to the interpretation of the records, as well as citations for both publications and archived data. The compiled data are available at https://doi.org/10.17864/1947.147
Evaluating model outputs using integrated global speleothem records of climate change since the last glacial
Although quantitative isotopic data from speleothems has been used to evaluate isotope-enabled model simulations, currently no consensus exists regarding the most appropriate methodology through which to achieve this. A number of modelling groups will be running isotope-enabled palaeoclimate simulations in the framework of the Coupled Model Intercomparison Project Phase 6, so it is timely to evaluate different approaches to use the speleothem data for data-model comparisons. Here, we illustrate this using 456 globally-distributed speleothem δ18O records from an updated version of the Speleothem Isotopes Synthesis and Analysis (SISAL) database and palaeoclimate simulations generated using the ECHAM5-wiso isotope-enabled atmospheric circulation model. We show that the SISAL records reproduce the first-order spatial patterns of isotopic variability in the modern day, strongly supporting the application of this dataset for evaluating model-derived isotope variability into the past. However, the discontinuous nature of many speleothem records complicates procuring large numbers of records if data-model comparisons are made using the traditional approach of comparing anomalies between a control period and a given palaeoclimate experiment. To circumvent this issue, we illustrate techniques through which the absolute isotopic values during any time period could be used for model evaluation. Specifically, we show that speleothem isotope records allow an assessment of a model’s ability to simulate spatial isotopic trends. Our analyses provide a protocol for using speleothem isotopic data for model evaluation, including screening the observations to take into account the impact of speleothem mineralogy on 18O values, the optimum period for the modern observational baseline, and the selection of an appropriate time-window for creating means of the isotope data for palaeo time slices
Hyponatremia in Geriatric Inhospital Patients: Effects on Results of a Comprehensive Geriatric Assessment
Objectives: To study whether geriatric patients with mildto-
moderate hyponatremia ( ^ 131 mmol/l) reveal different
outcomes in structured tests for functional and cognitive
impairments, depression and malnutrition compared to
normonatremic patients. Design: Single-center, retrospective
case control study. Setting: The study was conducted
in a Geriatric Evaluation and Management Unit of a Department
for Geriatrics and Internal Medicine. Methods and
Participants: We included 2,880 elderly patients (75.6% female,
mean age 78.6 8 6.98 years), consecutively admitted
to the GEMU primarily or from another hospital or emergency
department. Results were compared between a
group of 129 patients with mild-to-moderate hyponatremia
(118–131 mmol/l) and an age- and sex-matched control
group of 129 patients with normal serum sodium values
( 1 135 mmol/l). To assess functional and cognitive status, depression
and malnutrition we used standardized tests of a
geriatric assessment. Results: 16.7% (n = 477) of the total
2,880 patients were hyponatremic ( ^ 135 mmol/l), 4.5% (n =
129) revealed moderate hyponatremia. Compared to the control group, these patients had significantly worse results
in all tests of the Geriatric Assessment, including Activities
of Daily Living, Mini Mental State Examination, Clock Completion
Test, Geriatric Depression Score, Tinetti Mobility Test
and the Timed Up&Go Test and the Mini Nutritional Assessment.
Comorbidities were assessed by the Charlson Comorbidity
Index and the Cumulative Illness Rating Scale with no
significant difference between the two groups. The hyponatremic
patients received significantly more medications
than the normonatremic control group, but we could not
find a significant difference with respect to the use of a distinct
single drug therapy. Conclusion: We were able to demonstrate
that geriatric patients with mild-to-moderate hyponatremia
revealed a significantly worse outcome in all
standardized tests of the geriatric assessment compared
to a normonatremic control group. Serum sodium levels
should therefore be considered when interpreting common tests of geriatric assessment