The Most Common Cardiovascular, Orthopedic, and Neurological Problems in the Elderly and Nursing Care

AIM: Health problems of the elderly in addition to purely medical constitute a complex and quite acute social, economic, psychological, and spiritual problem, which are growing unstoppably everywhere in the world. The main purpose of this study is to assess the general health of the elderly, to identify the most common pathologies, and to describe the role and responsibilities of the nurse in the elderly with cardiovascular, neurological, and orthopedic diseases, in all patients in geriatric clinics. METHODS: The method used during this study was conducted through a questionnaire of the elderly in geriatric centers. The paper includes data on patients during the period April–June, 2020. RESULTS: Data were observed on 300 elderly persons of whom 100 persons or 33% were female and 200 persons or 67% were male. The mean age of patients was 90 ± 65 years. These elderly people were given information about living conditions, social problems, diseases they had, etc. The most common pathologies of these elderly people studied were cardiovascular problems 25%, orthopedic problems 31%, and neurological problems 43%. We see that women are more predisposed to cardiovascular problems in 66% of cases compared to men in 34% of cases; most predisposed to orthopedic problems are again women in 55% of cases compared to men in 45% of cases and more predisposed to neurological problems are men in 60% of cases and women in 40% of cases, it is significant (p < 0.001). CONCLUSIONS: From the above data, it is noticed that almost all the elderly have a concomitant disease. The role of the nurse should be to focus on the daily monitoring of the patient’s condition, to identify in time the possible risks, and to explain to the patient how to take the therapy, how long to take this therapy, what may be the side effects and how medications should be combined.

Fatal air embolism: A grave complication during diagnostic flexible bronchoscopy

Flexible fiber-optic bronchoscopy is used to determine diagnoses in pulmonary diseases. It is considered as a safe procedure, although some complications might occur, one of which is cerebral air embolism. In this case, we present the air embolism after the bronchoscopy procedure, ending in fatality. We strongly recommend that bronchoscopists should keep this complication in mind and be aware of early symptoms pertaining to the patient's state of consciousness during bronchoscopy examination. Early treatment is essential in this situation.

Gossypiboma in abdomen: retained surgical gauze after a cesarean section

A mass formed around a cotton matrix left within the body is termed gossypiboma or textiloma. It is a rare complication of surgery most commonly seen after abdominal surgery. The time of presentation may range from early post-operative period to several decades later. We herein report on a case of gossypiboma. A 42-year old woman admitted to our hospital with abdominal mass. She had undergone a caesarean operation 2 years previously. The mass in the right quadrant was suspected by abdominal ultrasound and magnetic resonance imaging. The mass was removed by laparoscopy excision and the final diagnosis was gossypiboma.

A clinical case of perineal invasion from rectal carcinoma

We report a case of 62-year old women with skin infiltration in the perineal area after anterior rectal resection due to upper rectal cancer. Computed Tomography (CT) shows an intense infiltrative aspect of the lesion. The patient had a diffuse perineal infiltration predominantly at Levator Ani muscles and adhesions to the posterior parts of urinary bladder, uterus, vagina and perineal skin. The patient underwent surgery with colostomy to relieve the colonic tract due to obstruction and later was treated with chemo-radiation.

Comparison between transvaginal sonography after diagnostic hysteroscopy and laparoscopic chromopertubation for the assessment of tubal patency in infertile women

PURPOSE

Diagnostic hysteroscopy has become a well-established modality for evaluating the uterine cavity, but provides no information regarding tubal patency. The aim of the present study was to investigate the diagnostic value of transvaginal sonography (TVS), performed directly after diagnostic hysteroscopy, for assessing tubal patency in infertile women, and to compare the findings with those obtained by means of laparoscopic chromopertubation.

METHODS

A total of 56 infertile patients were referred to our endoscopic unit for laparoscopic chromopertubation in the period from September 2008 to January 2010. Diagnostic hysteroscopy, followed by TVS, was carried out prior to laparoscopic chromopertubation. The collection of free fluid in the pouch of Douglas was accepted as evidence of tubal patency. The findings of TVS and laparoscopic chromopertubation were compared. The data were analyzed for the sensitivity, specificity, accuracy, positive-predictivevalue, and negative-predictive value of the combination of hysteroscopy and TVS in detecting unilateral or bilateral tubal patency.

RESULTS

The presence of fluid in the pouch of Douglas was observed in 37 of the 56 cases. In 36 of these cases, unilateral or bilateral tubal patency was confirmed by laparoscopic chromopertubation. In 17 of the remaining 19 cases (without fluid in the pouch of Douglas during ultrasound), bilateral tubal occlusion was confirmed by laparoscopic chromopertubation. Diagnostic hysteroscopy followed by TVS showed a high sensitivity and specificity for the assessment of tubal patency.

CONCLUSIONS

TVS performed directly after diagnostic hysteroscopy in infertile patients provides additional nformation regarding tubal patency.