UNASSIGNED: The purpose of this study was to evaluate and compare the clinical and structural outcomes after arthroscopic repair of isolated supraspinatus tears in patients older than 70 years vs. patients younger than 50 years to determine whether age influences the treatment of these tears.
UNASSIGNED: We conducted a retrospective, comparative study of 87 shoulders of 86 patients older than 70 years who underwent rotator cuff repair after isolated full-thickness supraspinatus tear between January 2010 and December 2020. A control group of 87 patients younger than 50 years was matched for sex, body mass index, smoking habits, tendon retraction according to Patte and fatty infiltration according to Goutallier. Clinical assessment used Constant-Murley Score (CMS), age- and sex-matched Constant Scores and Subjective Shoulder Value at 6 months. Cuff integrity was evaluated using ultrasonography based on the Sugaya criteria, types I-II-III being considered as healed.
UNASSIGNED: The CMS significantly improved by +17.91 points in elderly patients compared with +7.47 points in controls (P < .1) and activity (P = .2), mobility (P < .1), and strength (P < .1). The adjusted CMS significantly improved by +24.94 in elderly patients compared with +8.49 points in controls (P < .1). The Subjective Shoulder Value improved by +29.48 points in elderly patients compared with +23.47 points in controls. The improvement was similar in both groups. (P < .10). Satisfaction was similar in both groups (P = .31). Regarding structural outcomes, patients younger than 50 years presented better results in terms of healing than patients older than 70 years, as the healing rate was 73.7% in the elderly group and 88.5% in the control group (P = .1). The clinical outcomes were not significantly associated with the tendon healing (P = .1).
UNASSIGNED: Functional gain for patients older than 70 years is better than their younger peers despite their low-grade healing. Arthroscopic repair after isolated supraspinatus tears should be considered as a valuable treatment regardless the age.

UNASSIGNED:

Delirium is a common complication developing in el­der­ly patients. Therefore, it is important to diagnose delirium earlier. Family caregivers play an active role in early diagnosis of de­lirium and build a bridge between health pro­fessionals and patients. The purpose of this research was to achieve the validity and reliability of the Turkish version of the Informant Assessment of Geriatric Delirium Scale (I-AGeD).

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UNASSIGNED:

This is a methodological study. The sample comprised 125 caregivers ac­cepting to participate in the study and offering care to older patients with hip fracture aged ≥60 years. Data were gathered preoperatively and on postoperative days 0, 1 and 2. After achieving the linguistic and content validity of the scale, the known-groups comparison was used to achieve its construct validity. The ROC curve analysis was made to determine the sensitivity and specificity of the scale. Item-total correlations, item analysis based on the difference between the upper 27% and lower 27%, Kuder–Richardson 20 (KR-20) coefficient and parallel forms reliability with the NEECHAM Confusion Scale were adapted to assess discriminant indices of the items in the I-AGeD.

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UNASSIGNED:

The item-total correlation coeffi­cients of the scale ranged from 0.54 to 0.89 and KR-20 coefficient ranged from 0.09 to 0.91 depending on the measurement times. According to the ROC curve analysis, the sensitivity and specificity of the scale were ≥ 91% and ≥ 96% respectively. The parallel forms reliability analysis showed a highly significant, strong negative relation at each measurement between the I-AGeD and the NEECHAM Confusion Scale. 

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UNASSIGNED:

The I-AGeD is valid and reliable to diagnose delirium in older Turkish patients in perioperative processes.

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UNASSIGNED:

Az idős betegeknél a delírium gyakran kialakuló szövődmény, ezért fontos korai diagnózisa. A gondoskodó családtagok aktív szerepet játszanak a delírium korai diagnózisában, és hidat építenek az egészségügyi szakemberek és betegek között. Kutatásunk célja az volt, hogy elérjük az Informant Assessment of Geriatric Delirium Scale (I-AGeD) török verziójának érvényességét és megbízhatóságát.

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UNASSIGNED:

Ez egy módszertani tanulmány. A minta 125 gondozóból állt, akik vál­lalták a részvételt a tanulmányban, és 60 éves vagy a feletti csípőtöréses idős be­tegeket gondoztak. Az adatokat műtét előtt és a műtét utáni 0., 1. és 2. napon gyűj­töttük össze. A skála nyelvi és tartalmi ér­vényességét elérve az ismert csoportok összehasonlítását alkalmaztuk a szerkezeti ér­vényesség eléréséhez. A ROC-görbe elemzését végeztük el a skála érzékenységének és specificitásának meghatározásához. Az elem-összeg korrelációk és az elemanalízis az alsó 27% és a felső 27% közötti különbségeken alapultak, a Kuder–Richardson 20 (KR-20) együtthatót, valamint a NEECHAM Konfúzióskálával való párhuzamos formák meg-bízha­tóságát alkalmaztuk az I-AGeD-elemek disz­kriminanciamutatóinak értékelésére.

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UNASSIGNED:

A skála elem-összeg korrelációs együtthatói 0,54-tól 0,89-ig terjedtek, és a KR-20 együttható 0,09-tól 0,91-ig terjedt a mérési időtől függően. Az ROC-görbe elemzése szerint a skála érzékenysége és specificitása ≥ 91% és ≥ 96% volt. A párhuzamos formák megbízhatósági elemzése minden mérésnél nagyon szignifikáns, erős negatív összefüggést mutatott az I-AGeD és a NEECHAM Konfúzióskála között.

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UNASSIGNED:

Az I-AGeD érvényes és megbízható eszköz a delírium diagnosztizálására idős török betegeknél a perioperatív folyamatok során.

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Introduction The global elderly population is expanding, with chronic conditions like diabetes diminishing their quality of life. Sodium-glucose co-transporter type 2 (SGLT-2) inhibitors hold promise in improving quality of life by addressing hypervolemia, obesity, and lipid irregularities. However, these drugs can lead to adverse effects, such as polyuria, dehydration, and weight loss, which may detrimentally impact older patients. We aimed to investigate the association between SGLT-2 inhibitors and quality of life in older adults with diabetes. Methods The research included 100 type II diabetes mellitus patients over 65, without active infections, malignancies, immunodeficiencies, and hematological disorders. Fifty patients were using empagliflozin or dapagliflozin and 50 patients were using other oral antidiabetics for at least six months. Patient demographics, laboratory studies, drug usage and side effects, additional diseases, Geriatric Depression Scale scores, and World Health Organization Quality of Life OLD (WHOQoL-OLD) module scores were noted. Results No significant difference between gender distribution, SGLT usage, chronic disease existence, chronic disease count, depression scores, or incidents of chronic diseases other than hyperlipidemia was observed. Hyperlipidemia incidence was significantly higher in the SGLT group, while other laboratory parameters were not statistically significantly different between groups. There were no significant differences in autonomy, past-present-future activities, social skills, death, intimacy, and total WHOQoL-OLD scores between the two groups. However, there were statistically significantly worse outcomes in patients with at least one SGLT adverse effect in terms of sensory quality of life scores. Dehydration existence was negatively correlated with lower autonomy, PPF activities, and total quality of life scores. Multivariate linear regression analysis showed no significant differences in the total WHOQoL-OLD score after adjusting for confounding factors. Conclusion Age and depression remained the main factors affecting the quality of life in diabetic patients. SGLT-2 inhibitor side effects did not decrease the quality of life in older individuals, who are more prone to unfavorable consequences.

UNASSIGNED: Across the world, 25-hydroxyvitamin D (25-OHD) deficiency is a major health problem associated with many chronic diseases in the geriatric population. Prior to this study, there were no data regarding 25-OHD levels among individuals over the age of 65 in Turkey. The aim of this study was to assess 25-OHD levels and seasonal variations in these values among people over the age of 65 in Turkey.
UNASSIGNED: This study included vitamin D measurements taken in 2016, 2017, and 2018 from the Turkish population over the age of 65. The age, gender, and seasonal average data of the study population were defined. The study data were obtained from the database of the Ministry of Health, and a Kolmogorov-Smirnov test was used to assess the distribution of the data. Medians and interquartile ranges (IQRs) were calculated for all categories, as the data were nonparametric.
UNASSIGNED: The number of vitamin D measurements taken from the geriatric individuals included in this study was 305,329 for 2016, 576,452 for 2017, and 752,837 for 2018. The medians and IQRs of the 25-OHD levels in this population were 16 μg/L (IQR 7.45-24.55 μg/L) for 2016, 16.1 μg/L (IQR 7.8-24.4 μg/L) for 2017, and 16.4 μg/L (IQR 8.95-23.85 μg/L) for 2018.
UNASSIGNED: While the 25-OHD levels of older men tended to increase during the period of seasonal sunlight in Turkey, this variability was observed in elderly women. This suggests that older women tend to live more sedentary lives and have insufficient sun exposure. Overall, the median 25-OHD levels of individuals over the age of 65 tended to decrease each year.
UNASSIGNED: Širom sveta, nedostatak 25-hidroksivitamina D (25-OHD) je veliki zdravstveni problem povezan sa mnogim hroničnim bolestima u gerijatrijskoj populaciji. Pre ove studije, nije bilo podataka o nivoima 25-OHD me u pojedincima starijim od 65 godina u Turskoj. Cilj ove studije je bio da se proceni nivo 25-OHD i sezonske varijacije ovih vrednosti kod ljudi starijih od 65 godina u Turskoj.
UNASSIGNED: Ova studija je uključila merenja vitamina D uzeta 2016, 2017. i 2018. godine od turske populacije starije od 65 godina. Definisani su podaci o starosti, polu i sezonskom proseku ispitivane populacije. Podaci studije su dobijeni iz baze podataka Ministarstva zdravlja, a za procenu distribucije podataka korišćen je Kolmogorov-Smirnov test. Medijani i interkvartilni rasponi (IKR) su izračunati za sve kategorije, pošto su podaci bili neparametrijski.
UNASSIGNED: Broj merenja vitamina D uzetih od gerijatrijskih pojedinaca uključenih u ovu studiju bio je 305.329 za 2016, 576.452 za 2017. i 752.837 za 2018. Medijani i IKR nivoa 25-OHD u ovoj populaciji su bili 16 mg/L IKR 7,45-24,55 mg/L) za 2016, 16,1 mg/L (IKR 7,8-24,4 mg/L) za 2017, i 16,4 mg/L (IKR 8,95-23,85 mg/L) za 2018.
UNASSIGNED: Dok je nivo 25-OHD kod starijih muškaraca imao tendenciju povećanja tokom perioda sezonske sunčeve svetlosti u Turskoj, ova varijabilnost je primećena kod starijih žena. Ovo sugeriše da starije žene imaju tendenciju da žive više sedentarno i da su nedovoljno izložene suncu. Sve u svemu, srednji nivoi 25-OHD kod osoba starijih od 65 godina su se smanjivale svake godine.

BACKGROUND: The aim of this study was to clarify the prognostic value of the pathological lymph node ratio for older adult and younger adult gastric cancer patients and to evaluate whether there is a difference in the survival of patients with the same lymph node ratio (LNR).
METHODS: A total of 222 patients diagnosed with locally advanced gastric cancer who underwent upfront gastrectomy without neoadjuvant chemotherapy and had negative surgical margins were included. The patients were divided into two groups according to age. Clinicopathological properties of the two groups were compared. Potential prognostic factors affecting survival were analyzed. Subsequently, the effect of lymphadenectomy and LNR on survival in both groups was evaluated.
RESULTS: Thirty patients with perioperative mortality were excluded and 192 patients were analyzed. Significant differences were detected in terms of hemoglobin and albumin levels between older adult patients and younger adult patients (p < 0.05). Overall survival (OS) was significantly worse in older adult patients (22 months vs. 67 months, p < 0.001). The survival rates in older adult patients were significantly lower from those of younger adult in the subgroup LNR Stage 2 (12.1% vs. 47.9%, p = 0.004) and LNR Stage 3 classification (9.1% vs. 34.1%, p = 0.039). LNR was found to be significant for OS with a cut-off point of 0.18.
CONCLUSIONS: A survival difference was found between the older adult and younger adult patients with the same LNR. LNR was found to be an independent factor for survival especially in older adult patients. Survival was found to be further decreased in older adult patients compared to younger adult patients with increasing LNR.

Introduction Elderly patients are more prone to surgical risk regardless of the procedure. The overall mortality rate is expected to be high in this population. The aim of this study was to evaluate the survival rates of octogenarians who underwent knee arthroplasty procedures. Methods Sixty-two knee arthroplasties were performed on 52 patients who were >80 years of age at the time of the operation between November 1996 and May 2014. The preoperative American Society of Anesthesiologists (ASA) classes were available for 45 procedures. The database of the Civil Registry Service was used to assess whether the patients were alive at the time of the study. If they were deceased, their dates of death were recorded. The five-, 10-, and 15-year survival rates of patients were determined. Results Thirty patients (57.69%) were alive and 22 (42.31%) were deceased at the time of analysis. Based on the 62 procedures, the mean age of the patients at the time of the operation was 82.56 ± 2.18 years. The mean time span between the operation and death of patients who passed away was 6.4 ± 4.66 years. The mean age of the patients who were alive at the time of the study was 86.63 ± 3.60 years. The mean time that had passed since the operation was 4.41 ± 2.9 years for living patients. Only one patient died during the first 90 days postoperatively. The one-year mortality rate was 4.84% (three patients). A Kaplan-Meier survival analysis revealed that the mean survival time of the patients was 6.4 years, and the median survival time was 5.6 years. The five-year survival rate was 59%, the 10-year rate was 19%, and the 15-year rate was 7%. Conclusion Octogenarians benefitted from knee replacement longer than expected. Early mortality risks can be avoided with proper patient selection.

BACKGROUND: Turner syndrome (TS) is a chromosomal condition that affects development in females, resulted from a complete or partial absence of the second X chromosome or from structural anomalies (mosaicism) of one X chromosome. TS is one of the most common sex chromosome disorders among live-born female births.
METHODS: We presented with a 63 y.o. Female, who admitted to our Hospital with a chief complaint of pain when urinating and frequent haematuria. She has a history of Turner Syndrome (45 XO). Local examination in the lithotomy position revealed labial agglutination involving the labia majora. We did a Cystoscopy to evaluate the bladder and urethra, and then biopsied the tissues. Vaginal Reconstruction was performed to repair the Labial Synechiae. The biopsy showed that this histological finding is consistent with Follicular Cystitis that could cause by chronic UTIs.
CONCLUSIONS: Labial Synechiae (LS), or Labial agglutination is a disorder of the female genitalia characterized by thin, membranous adherence of the labia. LS usually noted in female with numerous UTIs and vaginal infections. Goel et al confirmed that LS is not a congenital disorder. In a retrospective study, they found out that LS is probably caused by multiple numerous UTIs that may cause a membrane to formed around the labia. The negligence and chronicity of this condition may have thickened the synechiae, making it persist for a long time, and can actually cause a symptom to appear.
CONCLUSIONS: There is no literature to suggest any link between TS and LS directly.

The purpose of this study was to compare the operative mortality rate and outcomes of endovascular aneurysm repair (EVAR) between young and geriatric people in a single center.
Eighty-five patients with abdominal aortic aneurysms who underwent EVAR between January 2012 and September 2016 were included. Outcomes were compared between two groups: the young (aged < 65 years) and the geriatric (aged ≥ 65 years). The primary study outcome was technical success; the secondary endpoints were mortality and secondary interventions. The mean follow-up time was 36 months (3-60 months).
The study included 72 males and 13 females with a mean age of 71.08±8.6 years (range 49-85 years). Of the 85 patients analyzed, 18 (21.2%) were under 65 years old and 67 patients (78.8%) were over 65 years old. There was no statistically significant correlation between chronic disease and age. We found no statistically significant difference between aneurysm diameter, neck angle, neck length, or right and left iliac angles. The secondary intervention rate was 7% (six patients). The conversion to open surgery was necessary for only one patient and only three deaths were reported (3.5%). There was no statistically significant difference in the mortality and reintervention rates between the age groups. The three deaths occurred only in the geriatric group and two died secondary to rupture. Kidney failure was observed in three patients in the geriatric group (4.5%).
Our single-center experience shows that EVAR can be used safely in both young and geriatric patients.

The use of physical restraint with the elderly remains a much-debated topic. Its use remains criticised and is also something of a paradox given its practice in this kind of facilities. All health professionals may use it in their daily practice, in a wide variety of situations.

BACKGROUND: This review attempts to summarise what is known about Drug-drug interactions (DDIs) of the new oral anticoagulants (NOACs) in elderly patients. The literature was searched for: \'CYP3A4\', \'CYP2C9\', \'P-glycoprotein\', \'acetylsalicylic-acid\', \'non-steroidal anti-inflammatory\', \'clopidogrel\', \'ticagrelor\', \'prasugrel\' and \'dabigatran\', \'rivaroxaban\', \'edoxaban\', or \'apixaban\'. \'Elderly\' was defined as ≥75 years. Areas covered: Publications about DDIs of NOACs were found for 35% of 140 potentially interacting drugs. Reports about DDIs of cardiovascular drugs, were most frequent, followed by anti-infective and nervous system drugs. Reports about elderly were found for only 47 patients. DDIs were reported most frequently in association with dabigatran. Dabigatran is the only NOAC interacting with proton-pump-inhibitors. Expert commentary: Dabigatran was the first NOAC approved, so it is not possible to determine whether the higher number of reports about DDIs with dabigatran compared with other NOACs is due to a higher rate of DDIs or to the length of time during which this drug has been in use. Most of the data is derived from subgroup-analyses of trials, sponsored by NOAC manufacturers, consequently there is a lack of independent data. Because of the scarcity of data, the clinical relevance of DDIs of NOACs is uncertain at present, especially in elderly patients.