No abstract available.
Aged, 80 and over* ; Humans

A case of radicular pain that resulted from a gas-filled intradural cyst in an 80-year-old male is described. Temporary improvement of radicular pain was observed after CT-guided aspiration. However, recurrent radicular pain led to surgical treatment. In this report, the authors document the radiologic and intraoperative features of a gas-filled intradural cyst that migrated into the nerve root, and propose an optimal treatment plan based on a review of the literature.
Aged, 80 and over ; Humans ; Male

This study aims to determine pre-morbid parameters as possible predictors of outcome of hip fracture in octogenarians with unstable intertrochanteric fracture treated operatively. Presence of co-morbidities, pre-injury level of ambulation, type of surgery, and period of delay in surgery were considered, and their effect on the post-operative outcome was evaluated using the Harris Hip Score. The computed probability of survival of octogenarians who had surgery was approximately 11 months. In patients with two or more co-morbidities, there is a significant effect on Harris Hip Score in terms of pain and deformity. Delay in surgery of more than two weeks significantly decreased the distance travelled at one year. The overall recovery is correlated to preinjury level of ambulation and delay in surgery. Patients with intertochanteric fracture in this age group, who have less co-morbidities and with more independent ambulation, are good candidates for timely operative treatment.
Aged, 80 and over ; Hip Fractures

No abstract available.
Aged, 80 and over* ; Dementia* ; Humans

Background: Maintaining optimal well-being of the elderly is now a major concern since their numbers are expected to swell in the next decades. Thus, there is a need to focus on the health and psychosocial status and needs of our older persons. Objective: To describe the biopsychosocial profile and needs of older persons in Davao City. Methodology: This study utilized secondary data obtained from the OPS 2009 survey after informed consent was sought from the DCOP-RG. The OPS 2009 survey was developed by a multidisciplinary group of professionals commissioned by the Davao City Sangguniang Panglungsod in order to create a basis for the implementing rules of the expanded senior citizen act for Davao City. It included 398 respondents age 60 and above who gave consent, representing the population of older persons from the different areas in Davao City. Data gathering was done by a team of trained interviewers. Anonymized gathered in OPS 2009 survey was utilized for this present study. Descriptive statistics were used to summarize the data. Results: There was an equal sex distribution among the respondents. Majority were married, widowed and Roman Catholics, 76.6% of the respondents believed that they were in good health. 60.1% of the respondents had previous admissions but even so, majority (87.9%) had someone to help take care of them during their admissions. Psychosocial status of the older persons was favorable in general. Majority (72.2%) still engage in recreational activities. Furthermore, the respondents have a happy disposition in life wherein majority have a perceived happy mood left contented and at peace. Almost all (98%) still feels needed by their kin and friends. Perceived health needs include better medical benefits while perceived psychosocial needs include financial and moral support. Conclusion: The study showed that older persons in Davao City perceived themselves to be happy, contented, calm, at peace and important to their families. However, since most were diagnosed with chronic illnesses such as hypertension, arthritis, diabetes, and asthma; health related needs and provision of better medical benefits topped their list. Financial support and psychosocial support from their families, government and non-government institutions were also listed as needs. In general, they envisioned Davao to be an older person friendly place with program that put elderly welfare, safety and protection at the forefront.
Aged 80 and over ; Aged ; FRAIL ELDERLY

Objective: To determine if there is a significant difference between the prevalence of depression in institutionalized and non-institutionalized elderly individuals. Methodology: Sixty female individuals 65 years and above were included in the study, thirty from the community while the other thirty reside in an institution for the elderly. The Mini Mental Status Examination was used to establish absence of cognitive impairment in the population, after which the Geriatric Depression Scale was administered. Results: The prevalence of depression in both institutionalized and non-institutionalized elderly individuals was 20 percent. The symptoms of depression in the two groups could be considered as depressive episodes since they were transient and did not result in any deterioration of their function. Conclusion: The finding of this study showed that there was no difference between the prevalence of depression in institutionalized and non-institutionalized elderly individuals.
Human ; Female ; Aged 80 and over ; Aged ; DEPRESSION ; AGED

"Pride goeth before destruction, and an haughty spirit before a fall.

Better it is to be of an humble spirit with the lowly,

than to divide the spoil with the proud."

- Proverbs 16:18-191

There is justifiable pride in completing the arduous journey: the 4- to 5-year post-baccalaureate Doctor of Medicine degree capped with a grueling year of internship, passing the professional licensure examinations, obtaining a 3- to 7-year post-graduate residency training, hurdling Diplomate specialty board examinations, perhaps even completing a 1- to 2-year clinical and/or research fellowship subspecialty qualification and becoming a full-fledged Fellow of a specialty society, college, or academy after a 2-year probation or initiation period. A full 15 to 20 years after High School, you are finally on your own. Armed with encyclopedic knowledge and cutting-edge skills, you confidently (even cockily) set out to conquer case after clinical case as you "exercise awesome power over life and death."2 You may even succeed in your campaign for some time, and pride can easily bloat out of proportion into hubris -- "excessive pride toward or in defiance of the gods, leading to nemesis."3 Thus was the weaver Arachne transformed into a spider after challenging (and being defeated by) the goddess Athena.4

Unfortunately, Arachne was oblivious to her web. You would not be where you are were it not for the countless people who directly or indirectly supported you throughout your journey. Your parents and family, clan and community, teachers and classmates were certainly there. But more than them, the nameless--even faceless-- others whose lives and services (yes, including the cadaver you dissected in anatomy) made yours possible were also there. Ultimately, many others had to die, figuratively and literally, so that others-- you included-- may live. The very persons you now perceive as patients represent the collective people (living and dead) who made your becoming a physician possible. You owe them.

If you still have not learned by now, patients are not cases to be solved, but persons to serve. Engaging whole but broken people, people in pain or dis-ease, entails more than expert knowledge and sharply honed skills. As Sir William Osler said, "To know the patient that has the disease is more important than to know the disease that the patient has."5 Head and hands are worthless without heart. Competence needs to be motivated by compassion and enabled by communication. It has little place for pride, and none for hubris. On the contrary, its primary stance is one of humility-- true concern for others as opposed to self-concern: 6

"Do not imagine that if you meet a really humble man he            will be what most people call 'humble' nowadays: he will not              be a sort of greasy, smarmy person, who is always telling you          that, of course, he is nobody. Probably all you will think about          him is that he seemed a cheerful, intelligent chap who took a            real interest in what you said to him. If you do dislike him it              will be because you feel a little envious of anyone who seems               to enjoy life so easily. He will not be thinking about humility:              he will not be thinking about himself at all."

      This concern for others, rather than for the self, may mark the so-called "sweet spot between hubris and humility" where one feels "small and insignificant but empowered at the same time."7 Being confronted by, and surmounting the tension between life and death with each patient encounter (some more than others) redefines and reinforces this spot over and over again -- but not without taking its toll. After so many years, a part of me still dies with each patient's death. I suppose that one cannot deal with wellness and illness, and living and dying, without sustaining collateral damage in the process-- far beyond the inevitable wear and tear that accompany our own aging process. And this is a truly humbling realization.

We can choose to wallow in self-pity, and even despair. Or we can bracket our pains and concerns, and practice the compassion of the wounded healer, where "in our own woundedness, we can become as source of life for others."8 Compassion is enabled and concern communicated when we ourselves embrace pain, dis-ease and brokenness--ours, as well as that of our patients. It is not easy, but we fully begin to serve as worthy instruments of healing when with each death, we die; and with each life, we live again.

Fractures of the femoral shaft with marked bowing face some obstacles in fixation of the fracture such as difficulty in insertion of the intramedullary nail (IM nail) or exact contouring plate. Locking compression plates (LCP) are an option to manage this problem. However, we experienced consecutive breakage of LCP twice and IM nail once in an 80-year-old female. Finally, union of the fracture was achieved after fixation of the IM nail and additional plate together. Fractures of the femur shaft with marked bowing are thought to have different biomechanical properties; therefore, we present this case with a review of the literature.
Aged, 80 and over ; Female ; Femur ; Humans ; Nails

Sebaceous carcinoma is an uncommon neoplasm usually associated with ocular adnexa. This malignancy may occur at any anatomic site that contains sebaceous glands. Despite the widespread anatomic distribution of sebaceous glands, extraocular sebaceous carcinoma occurs with far less frequency. We report a case of an 87-year-old Korean woman with extraocular sebaceous carcinoma treated with total excision.
Aged, 80 and over ; Female ; Humans ; Sebaceous Glands

Chondrodermatitis nodularis chronica helicis is a painful erythematous, often crusted, papule most commonly found on the helix of the ear of men over the age of 40 years. It is seen less commonly in women, in whom it is usually located on the antihelix. The lesions usually occur unilaterally, although bilateral involvement has been reported. We report an unusual case of chondrodermatitis nodularis chronica helicis in an 86-year-old woman, which presented with bilateral involvement of the concha of auricles.
Aged, 80 and over ; Ear ; Female ; Humans ; Male