沈阳市961名老年干部牙健康状况调查

目的了解并分析沈阳市老年干部牙健康状况。方法按第二次全国口腔健康流行病学抽样调查标准,对沈阳市961名60岁以上的老年干部进行口腔健康调查,结果用SPSS软件处理。结果患龋率为67.12%,患龋者的龋均随着年龄的增长而逐渐增高(P<0.05),龋齿全部充填率为33.18%。缺牙率为80.65%,人均失牙7.38颗,人均保留牙的数目与年龄呈负相关(P<0.01)。无牙牙合率为10.20%,无牙牙合与牙列缺损的修复率分别为98.98%和36.04%。牙周健康状况与年龄呈负相关(P<0.01)。结论牙列缺失及缺损是老年人常见的口腔疾患,龋病和牙周病是其主要原因。加强老年人的口腔保健意识,是提高口腔疾病治疗成功率的重要环节,进而增进老年人的全身健康。     

瑞波西汀与多虑平治疗老年抑郁症对照研究

目的观察瑞波西汀治疗老年抑郁症的疗效和安全性。方法随机将60例年龄≥60岁的老年抑郁症患者分为多虑平组（30例）和瑞波西汀组（30例），疗程6周，采用汉密尔顿抑郁量表（HAMD）和副反应量表（TESS）在治疗前和治疗后1、2、4、6周末评定药物疗效和副反应。结果两组疗效无显著差异，HAMD总分反各因子分从疗后2周至6周均较治疗前显著降低，两组间比较无显著性差异；治疗结束时TESS评分瑞波西汀组显著低于多虑平组。结论瑞波西汀适合于老年抑郁症患者的治疗，服用方便、安全，可首选使用。     

Guardians of health: The dimensions of elder caregiving among women in a Mexico City neighborhood

Little is known about the family care of older adults in Mexico and the role of women in this process. To begin to fill this knowledge gap, this paper describes how a small sample of low-income women in one Mexico City neighborhood conceptualized the caregiver role and identified the forms of assistance they gave to their older relatives on a daily basis. A grounded theory approach was used to collect and analyze the data. Forty-one semi-structured qualitative interviews were conducted with female caregivers. The age of participants was between 19 and 83 years, and care recipients between 56 and 92 years. The relationship of caregiver to care recipient was wife, daughter, daughter-in-law, granddaughter, sibling, and other relative. The mean length of time providing care was 5 years. Most participants were not employed outside the home, and the median monthly household income was 2000 pesos. We found that caregiving was a life-changing event, with 27 of 41 participants viewing themselves as guardians. Caregivers' emphasis was on care recipients' emotional needs in order to provide “the most precious gift” of “time and attention.” Two forms of assistance were ‘keeping company’ and ‘watching out’ as safeguards against poor health or further decline in health. These findings increase the cultural understanding of caregiving in Mexico. Further research is needed to test the caregiving concepts identified in this study.     

Bilateral Mid-Diaphyseal Femoral Stress Fractures in the Elderly

Abstract Background: Osteoporosis is characterized by low bone density and poor bone mineralization. Mid-diaphyseal stress (insufficiency) fractures of the femur caused by osteoporosis are rare. The symptoms of these lesions are vague and confusing. The physician must be alert to the possibility of femoral shaft stress fractures when evaluating an elderly patient complaining of back, hip or leg pain. Case Study: A 72-year-old osteoporotic female patient with bilateral mid-diaphyseal stress fractures of the femur is reported. The diagnosis of femoral shaft stress fracture in the elderly is very difficult when based on physical findings and plain radiography only. A magnetic resonance imaging (MRI) scan or nuclear scintigraphy is necessary for early diagnosis. In the described case, the patient had an excellent result after surgical treatment with intramedullary nails. Conclusion: MRI or nuclear scintigraphy must be obtained to exclude the possibility of femoral shaft stress fractures in the elderly. In the absence of contraindications, surgery is the best solution for this kind of lesion.     

老年期抑郁症病人听觉事件相关电位P300的比较研究

目的 探讨老年期抑郁症病人的认知功能状况。方法 按CCMD-3中心境障碍抑郁发作诊断标准，收集33例60岁以上首次抑郁发作的病人(抑郁组)，32名健康老年人(对照组)。使用HAMD、HAMA和MMSE量表对所有入组者进行评定，并作P300测定。结果 抑郁组MMSE总分低于对照组。抑郁组N2和P3潜伏期比对照组延长；抑郁组的P300潜伏期N2和P3与HAMD的迟缓因子分呈正相关，与MMSE总分呈负相关。结论 老年期抑郁症病人存在认知功能障碍。     

Amputation of a crossover 2nd toe in the presence of hallux valgus

Background: There are many surgical procedures for the correction of hallux valgus and crossover 2nd toe deformity. Amputation of a crossover 2nd toe is often performed as a salvage procedure if the primary 2nd toe corrective procedure fails.Aims: To assess the outcomes of amputating a crossover 2nd toe in the presence of hallux valgus in elderly patients above 70 years old; as a primary procedure.Materials and methods: Seven patients (8 ft) underwent amputation of their crossover 2nd toe. A disease specific questionnaire using a Visual Analogue Scale (VAS) was implemented measuring pain, deformity, discomfort, and walking distance.Results: The mean age of the patients was 82 years old, range 74–89 years old. Amputation of the 2nd toe significantly reduces pain, discomfort and the appearance of deformity, there was no difference in the patient’s walking distance after surgery.Conclusion: We recommend this type of surgery as a primary procedure in elderly patients above 70 years old, if the first ray is not causing symptoms.     

Experiences of pain and distress in hip fracture patients

The aims were to investigate: (1) experiences of physical pain in elderly patients with hip fracture; (2) if background variables, confusion, experiences of pain and distress and interventions aimed at reducing pain and distress, functional ability, pain in the ambulance, and type of fracture varied between patients with more intense physical pain and patients with less intense physical pain. The sample included 49 patients, 70 years or older, with hip fracture. Structured instruments were used to interview and observe the patients on four occasions during the hospital stay. The patients’ experiences of physical pain decreased during the hospital stay. Physical pain at rest was lower than pain with movement. Patients who scored physical pain as more intense (group B) during the visit to the hospital had significantly more unfavourable experiences in the sensory, emotional, and existential dimensions the day before discharge from the hospital compared with the patients who scored pain as less intense (group A). The patients in group B perceived the interventions as less favourable than group A. Furthermore, group B had more intense physical pain in the ambulance than the patients in the other group. More patients in group B than in group A had additional health problems.     

舒降之治疗老年人高脂血症的疗效观察

目的：观察舒降之（辛伐他汀）20mg每日一次降脂的临床疗效。方法：选35例老年高脂血症患者接受舒降之20mg,每日1次（晚上顿服）治疗,疗程8周。观察治疗前后血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）。结果：治疗8周后,血清TC、TG、LDL-C较入组前分别降低了29.20%、24.75%、32.87%（均P〈0.01）,其中,降低TC的总有效率为93.54%、降低TG的总有效率为59.26%。HDL-C较入组前升高了14.12%（P〈0.01）,升高HDL-C的总有效率为54.54%。结论：舒降之20mg,每日1次服用,安全有效,对改善老年人高脂血症有显著疗效。     

老年人腹腔镜胆囊切除术172例报告

目的 :探讨老年人腹腔镜胆囊切除术的安全性、可行性及注意点。方法 :对 172例老年人胆囊良性病变进行腹腔镜胆囊切除术。其中伴有并存病 96例 (5 5 .81% )。结果 :172例病人均恢复良好 ,无并发症发生 ,无中转开腹病例。结论 :只要做好围手术处理 ,老年人行腹腔镜胆囊切除术是安全可行的。     

A Study of Fluoxetine in Obese Elderly Patients with Type 2 Diabetes

In order to establish the safety and efficacy of fluoxetine in subjects over 60 years of age with Type 2 diabetes, a randomized, double-blind, parallel study of 30 obese subjects was undertaken, comparing the use of fluoxetine 60 mg daily with placebo. Subjects were diet controlled with an HbA₁ < 14% (reference range 6–9%) and BMI > 29 kg m². Those taking fluoxetine had a median weight loss of 2.6 kg at 3 months (p < 0.001) and 3.9 kg at 6 months (p < 0–02), compared with weight loss in the placebo group of 0.1 kg and 0.0 kg at 3 and 6 months, respectively. Improved glycaemic control was also demonstrated in the fluoxetine group compared with placebo, initial HbA₁ levels of 8.0% vs 8.7% (NS) falling at 4 months by 0.9% (p < 0.02) and at six months by 0.9% (p < 0.02). No sustained improvement in fasting blood glucose levels was demonstrated. Reporting of adverse events was similar in both groups. Fluoxetine in the short term aids weight loss and improves glycaemic control without a significant increase in adverse events in elderly Type 2 diabetic subjects.