Cost Analysis of Emergency Department Visits by Geriatric Patients Living in Nursing Homes.

OBJECTIVE: To determine the cost analysis of emergency department (ED) visits by geriatric patients living in nursing homes. STUDY DESIGN: Cross-sectional study. METHODOLOGY: Medical records of geriatric patients living in nursing homes who were admitted to the emergency department of the Hospital, between 2011 and 2015, were retrospectively reviewed. Number of visits, reason, and cost of treatment was determined. RESULTS: In total 63 patients (21 females [33.3%], 42 males [66.6%]) with mean age of 76.3 ± 8.16 years were included. The total number of emergency department visits by those 63 patients was 243. Twenty-three (9.5%) of the total emergency department visits were due to trauma. Six patients (9.5%) were admitted to the emergency department with cardiopulmonary arrest. The mean cost of each patient was $358.30 (53.90 - 1734.10), the maximum cost was$10,095.10, and the minimum cost was $7.42. CONCLUSION: Emergency department visits and hospitalisation are common among elderly patients living in nursing homes. However, emergency department visits by this frail population put a heavy burden on the economy. Essential measures should be taken to reduce the financial burden of emergency department visits and hospitalisation of this geriatric population

Cost Analysis of Emergency Department Visits by Geriatric Patients Living in Nursing Homes

Objective: To determine the cost analysis of emergency department (ED) visits by geriatric patients living in nursing homes.Study Design: Cross-sectional study.Methodology: Medical records of geriatric patients living in nursing homes who were admitted to the emergency department of the Hospital, between 2011 and 2015, were retrospectively reviewed. Number of visits, reason, and cost of treatment was determined.Results: In total 63 patients (21 females [33.3%], 42 males [66.6%]) with mean age of 76.3 +/- 8.16 years were included. The total number of emergency department visits by those 63 patients was 243. Twenty-three (9.5%) of the total emergency department visits were due to trauma. Six patients (9.5%) were admitted to the emergency department with cardiopulmonary arrest. The mean cost of each patient was $358.30 (53.90 - 1734.10), the maximum cost was$10,095.10, and the minimum cost was $7.42.Conclusion: Emergency department visits and hospitalisation are common among elderly patients living in nursing homes. However, emergency department visits by this frail population put a heavy burden on the economy. Essential measures should be taken to reduce the financial burden of emergency department visits and hospitalisation of this geriatric population.C1 [Seyit, Murat; Yilmaz, Atakan; Ozen, Mert] Pamukkale Univ, Dept Emergency Med, Med Sch, Denizli, Turkey.[Seyit, Duygu Aras] Dumlupinar Univ, Evliya Celebi Res & Training Hosp, Dept Neurol, Kutahya, Turkey

Acid in Rats with Streptozotocine Induced Diabetic Neuropathy

Introduction: Neuropathy is a common complication of diabetes mellitus and is closely related to quality of life. There are many studies in which biological ingredients, such as alpha lipoic acid (ALA), that may inhibit or reduce the generation of diabetic neuropathy were investigated. Another biological agent that may reduce the generation of diabetic neuropathy is melatonin and there are a few studies that investigate the effects of melatonin on diabetic neuropathy. In this study we aimed to examine the effect of melatonin on experimentally induced diabetic neuropathy by comparing it with both ALA and control groups.Methods: We included 24 male Wistar rats. Tibial motor nerve conduction and cortical tibial nerve somatosensory evoked potentials (SEP) studies were performed before and after diabetes mellitus (DM) for all rats. Rats were divided into 3 (ALA, melatonin and control) groups. After 2 weeks of treatment period, tibial motor nerve conduction and cortical tibial SEP studies were repeated.Results: Our data showed that ALA significantly increased nerve conduction velocity and ampli-tude in rats with diabetic neuropathy (p = 0,001; p = 0,002). Also, melatonin significantly increased nerve conduction velocity and amplitude in rats with diabetic neuropathy (p = 0.002; p = 0.002). There was no significant difference between the electrophysiological effects of ALA and melatonin. Besides, neither ALA nor melatonin did significantly affect P1 and N1 latency values on cortical tibial nerve SEP studies.Conclusion: Our study is the study in which both tibial nerve conduction and cortical tibial SEP studies were performed to compare effects of ALA and melatonin on experimental diabetic neuropathy. Lack of significant difference on cortical tibial SEP study would be attributed to the involvement of other central nervous system pathways which do not include ALA or melatonin in the pathogenesis. Results of ALA group are important by means of giving objective evidences for results of biochemical studies about the role of ALA in the pathogenesis of diabetic neuropathy. However, there is not enough information about the effect of melatonin in the pathogenesis of diabetic neuropathy. Consequently, results of our study may anticipate further biochemical and clinic studies which investigate the about the role of melatonin in diabetic neuropathy

Evaluation of Electrophysiological Effects of Melatonin and Alpha Lipoic Acid in Rats with Streptozotocine Induced Diabetic Neuropathy.

INTRODUCTION: Neuropathy is a common complication of diabetes mellitus and is closely related to quality of life. There are many studies in which biological ingredients, such as alpha lipoic acid (ALA), that may inhibit or reduce the generation of diabetic neuropathy were investigated. Another biological agent that may reduce the generation of diabetic neuropathy is melatonin and there are a few studies that investigate the effects of melatonin on diabetic neuropathy. In this study we aimed to examine the effect of melatonin on experimentally induced diabetic neuropathy by comparing it with both ALA and control groups. METHODS: We included 24 male Wistar rats. Tibial motor nerve conduction and cortical tibial nerve somatosensory evoked potentials (SEP) studies were performed before and after diabetes mellitus (DM) for all rats. Rats were divided into 3 (ALA, melatonin and control) groups. After 2 weeks of treatment period, tibial motor nerve conduction and cortical tibial SEP studies were repeated. RESULTS: Our data showed that ALA significantly increased nerve conduction velocity and amplitude in rats with diabetic neuropathy (p=0,001; p=0,002). Also, melatonin significantly increased nerve conduction velocity and amplitude in rats with diabetic neuropathy (p=0.002; p=0.002). There was no significant difference between the electrophysiological effects of ALA and melatonin. Besides, neither ALA nor melatonin did significantly affect P1 and N1 latency values on cortical tibial nerve SEP studies. CONCLUSION: Our study is the study in which both tibial nerve conduction and cortical tibial SEP studies were performed to compare effects of ALA and melatonin on experimental diabetic neuropathy. Lack of significant difference on cortical tibial SEP study would be attributed to the involvement of other central nervous system pathways which do not include ALA or melatonin in the pathogenesis. RESULTS of ALA group are important by means of giving objective evidences for results of biochemical studies about the role of ALA in the pathogenesis of diabetic neuropathy. However, there is not enough information about the effect of melatonin in the pathogenesis of diabetic neuropathy. Consequently, results of our study may anticipate further biochemical and clinic studies which investigate the about the role of melatonin in diabetic neuropathy

Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial

In order to evaluate whether nonsurgical periodontal treatment with/without diode laser (DL) decontamination improves clinical parameters, the levels of IL-1β, IL-6, IL-8, intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM) in gingival crevicular fluid and metabolic control (HbA1c) in chronic periodontitis (CP) patients with diabetes mellitus type 2 (DM2). Sixty patients with DM2 and CP were randomly assigned into two groups to receive scaling and root planing (SRP, n = 30) or SRP followed by diode laser application (SRP + DL, n = 30). Clinical periodontal and gingival crevicular fluid (GCF) parameters were assessed at baseline, 1, and 3 months after periodontal treatment. HbA1c levels were evaluated at baseline and 3 months post-therapy. Total amounts of cytokines and molecules were analyzed by ELISA. Nonsurgical periodontal treatment with/without DL appeared to improve clinical, biochemical parameters, and glycemic control in DM2 patients (BMI < 25 kg/m2) with CP. The SRP + DL group provided better reductions in probing depth (PD) and clinical attachment level (CAL) parameters compared to the SRP group (P < 0.05). Significant reductions were found in the total amounts of GCF levels of IL-1, IL-6, IL-8, ICAM, and VCAM after treatment (P < 0.05). HbA1c levels decreased significantly at 3 months after treatment (P < 0.05). SRP + DL reduced HbA1c levels more significantly compared to SRP alone (0.41 vs. 0.22 %, P < 0.05). SRP, especially in combination with DL, shows improvement of glycemic control for DM2 patients with CP