Clinical interventions in aging
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Observational Study
A novel pain assessment tool incorporating automated facial analysis: interrater reliability in advanced dementia.
Regardless of its severity, dementia does not negate the experience of pain. Rather, dementia hinders self-reporting mechanisms in affected individuals because they lose the ability to do so. The primary aim of this study was to examine the interrater reliability of the electronic Pain Assessment Tool (ePAT) among raters when assessing pain in residents with moderate-to-severe dementia. Secondly, it sought to examine the relationship between total instrument scores and facial scores, as determined by automated facial expression analysis. ⋯ ePAT, which combines automated facial expression analysis and clinical behavioral indicators in a single observational pain assessment tool, demonstrates good reliability properties, which supports its appropriateness for use in residents with advanced dementia.
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The aims of this study were to investigate the prevalence of frailty and its relationship with health care use among community-dwelling older adults with diabetes. ⋯ Our results highlight the high prevalence of frailty in community-dwelling older adults with diabetes. Furthermore, being frail is associated with a greater burden of hospitalizations and emergency department visits.
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Sympathovagal imbalance is a common underlying disorder in hypertension and diabetes. This study characterized autonomic nervous system function, indicated by heart rate deceleration capacity (DC) and deceleration runs (DRs), in patients with type 2 diabetes mellitus (T2DM), with or without concomitant essential hypertension. ⋯ Compared with healthy subjects, T2DM patients with or without essential hypertension have lower DC and DRs. DC and DRs correlate negatively with blood glucose and insulin resistance index.
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Cough on anesthetic emergence should be prevented considering its dangerous complications. Target-controlled infusion (TCI) of remifentanil can reduce emergence cough effectively, and sex-related differences in effect-site concentration (Ce) of remifentanil have been evaluated in young patients. In this study, we determined the Ce of remifentanil for preventing emergence cough following extubation in male and female elderly patients and evaluated the sex-related difference. ⋯ The remifentanil requirement for preventing emergence cough was lower in female than in male elderly patients, indicative of sex-related differences in Ce of remifentanil. Sex should be considered when using remifentanil TCI for preventing emergence cough in elderly patients.