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Artykuł z numeru specjalnego NS/2012 internetowego czasopisma edukacyjnego ORE "Trendy

Sexual dysfunction in elderly men and women

Background: The aging process of the body is inexorable and affects all areas of geriatric patient's life, including the quality of his sex life. In this case, however, also psychological and environmental problems must be taken into account in the case of diagnostics. The sexuality of elderly patients has been neglected by the medical community for many years, and even recognized by some doctors as unnecessary or bad. Currently, there is a slow change in this position, also due to the patients themselves who are looking for help in specific situations. Material and methods: Analysis of available literature, articles in the Google Scholar and PubMed database using keywords: Sexuality, Geriatrics, Dysfunctions Results: Statistics on the sexuality of the elderly give a clear picture of how great a problem this sphere of life is. The main risk factors for sexual dysfunction of the above-mentioned patients include, among others, abnormal lifestyle and urinary tract infections. In the patients' lifestyle the most important aetiological factors are incorrect diet or lack of physical activity. Men of all ages are exposed to problems, however, in the epidemiology of this dysfunction, a drastic jump after the age of 50 is noticed. It is connected with the weakening of the function of the nervous system and microcirculation in the urinary tract and the reduction of the number of hormones responsible for the functioning of sexual organs. In women, this menopause is the period that most destructively affects the quality of sexual life. Here, as in the case of men, a reduced amount of hormones has a negative effect, among others, by a reduced sexual desire or the presence of pain during intercourse. In the treatment of the above-mentioned disorders, mainly pharmacology has the largest field of action. In the treatment of sexual dysfunction, we mainly use 2 compounds and these are sildenafil and tadalafil. Conclusions: Human sexuality, especially in the case of older people, can not be a neglected subject, and dysfunctions and problems of patients treated like any other. The need to integrate interdisciplinary mode in dealing with this type of problems is more necessary. All this is connected with the fact that there is a definite deficit in publications and research on this subject, which creates a wide range of possibilities for the medical community

The impact of influenza on elderly patients

Background: Influenza is a disease affecting the human respiratory system. A common problem is to confuse colds with influenza, which results in problems with vaccination and complications related to influenza. Particular attention should be paid to the treatment of influenza, as it is a serious health risk if not treated in the elderly. Research conducted by scientists from Taiwan shows that currently the best way to protect against influenza is preventive vaccination. In addition to vaccination, antiviral drugs (Oseltamivir, Zanamivir, Amantadine, Rimantadine), antipyretics (aspirin, paracetamol) are used. Attention is paid to natural methods (ginseng extract, root lichen extract) and supplements (vitamin C, zinc). Material and Methods: This article is based on a review of the current state of knowledge on influenza in the elderly. The most up-to-date literature with EBSCO, Google Scholar and PubMed has been reviewed. Key words such as influenza, influenza complications, vaccinations, influenza treatment. Results: In the context of the above topics, particular attention is paid to the elderly, in whom a low level of immunity predisposes to getting sick. An increase in the incidence of disease causes an increase in the mortality of older people. Complications following the occurrence of influenza are closely related to the type of virus, where the influenza A virus classified as the heaviest in the course. It has been proven that the bird influenza virus is also a threat to humans. The classic symptoms of influenza are cough, fever, while complications associated with untreated influenza are primarily myocarditis or pneumonia. Conclusion: Due to the decline in immunity, older people are particularly at risk of influenza virus. Scientists have demonstrated the high effectiveness of protective vaccination, but one should remember to repeat them every year. Vaccinations in the elderly have reduced effectiveness, which is why antiviral therapies, natural methods and supplements are used. In the rational treatment of influenza, it is noted that natural methods and supplements are an addition to classic antiviral therapy

Pharmacotherapy of depression in palliative patients

Introduction: Depression often affects people suffering from serious illnesses, including oncological and palliative patients. It reduces their quality of life and worsens their prognosis. This is why it is so important to properly treat depression in palliative patients. Material and Methods: The information provided was collected as a result of analysis of various articles and textbooks on development, diagnosis and treatment, as well as prevention of depression in terminally ill patients using Google Scholar and PubMed databases. Results: The results show that the most common drug in therapy for palliative patients with depression are the sluggish serotonin reuptake inhibitors (SSRIs). SSRIs inhibit serotonin transporter reducing serotonin reuptake. This raises the level of neurotransmitter - serotonin - in the synaptic cleft. They are well tolerated and have fewer side effects than older antidepressants (tricyclic antidepressants and monoamine oxidase inhibitors). Tricyclic antidepressants may relieve neuropathic pain and they are also beneficial for patients with insomnia. Mirtazapine in addition to antidepressant effects also causes increasing appetite, reducing nausea and sedative effect. In cancer-diagnosed patients particular attention should be paid to side effects such as nausea and vomiting that may occur in patients undergoing radiotherapy and chemotherapy using SSRIs or TCAs. SSRI therapy have a good safety profile and also interacts less frequently, while atypical antipsychotics may reduce the discomforts of taking chemotherapy. An alternative method of treating depression is the use of psychostimulants such as methylphenidate. Another way to treat depression is psychotherapy. Conclusions: There are several options for treating depression in palliative patients. It is important to pay attention to the side effects of prescribed medicines. Nevertheless, the best results are obtained by combining pharmacotherapy with psychotherapy

A person with diabetes as a patient - basic rules of conduct

BACKGROUND: Diabetes is very widespread disease. More and more patients suffer from hyperglycaemia and low levels of insulin because of obesity, aging and wrong diet. The most important in treatment based on health condition is to normalize glucose level. It is recommended to treat patients to avoid many complications of hyperglycaemia, e.g. cardiovascular diseases, stroke episodes, neuropathy or nephropathy. The most common cause of death are cardiovascular problems and renal failure. MATERIAL AND METHODS: A proper review of published literature provide to define laboratory indexes, risk factors, complications to precise methods of treatment among patients with diabetes. RESULTS: The problem of growing number of people suffering from diabetes is an important issue to find solutions to conduct their treatment. Basic method is a change of diet and body loss. The most important medicament in treatment is metformin. To achieve the best results of conducting therapy should be extended by pioglitazone or liraglutide. Also addition of aspirin lower dyslipidemia problems. Such a combination provides to minimise side effects of sickness. CONCLUSIONS: Number of people suffering from DM is still and will be growing over the next years. It is significant to diagnose these people because untreated diabetes provides to many complications e.g. stroke or acute coronary syndrome. It is important to examine patients correctly what allows to turn on correct treatment. Basic standards in treatment should contain lower glucose levels, avoid complications to enhance life quality. . Expanded therapy is also concentrated on hypertension, acidosis and ketoacidosis coma to obtain beneficial effects

Insomnia in elderly patients – various ways to manage

Introduction: Impaired duration, rhythm and depth of sleep and wakefulness called insomnia is a common problem in the group of geriatric patients. About 50% of elderly people report insomnia. Material and Methods: The paper reviews literature using the EBSCO and Google Scholar databases. Articles have been analyzed using the keywords insomnia, elderly patients, prevalence and etiology, primary care, treatment, diet, physiotherapy. The article presents various methods to manage insomnia among the elderly. Results: The main treatment for insomnia includes pharmacological and non-pharmacological interventions or a combination of both. A very important aspect is proper dietary, physiotherapy treatment and physical activity. Conclusions: Effective management of sleep disorders improves the quality of life of patients struggling with this disorder and prevents the occurrence of depression and anxiety, which often coexist with insomnia

Laboratory tests in geriatric patients - an overview of the latest reports

Laboratory tests are extremely important in patient’s monitoring and/or diagnosing. We described those that are particularly significant for elderly patients, namely: peripheral blood morphology, arterial blood gasometry, cancer markers. The aim of this article is to summarize current knowledge about laboratory tests important in geriatrics, as well as draw attention to the diverse use of laboratory tests in clinical practise