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Physical frailty is a common characteristic of older people with the ageing process and has been viewed as a major public health issue. The longitudinal association between different social engagement and physical frailty among older people has not been explored adequately in China. Marital status forms a critical context for the link between social engagement and frailty among older people, which might constitute a moderating process. The purpose of the present study is to investigate the longitudinal association between social engagement and the changes in physical frailty among Chinese older adults, and to examine whether the association between social engagement and frailty differs by marital status.

The data use in this study were from the data from the China Health and Retirement Longitudinal Study aged 60+ years from 2011 to 2015. A total of 6575 respondents who participated in at least one follow-up wave were included in the analysis. The relationship between social engagement and changes in frailaging unmarried older adults to engage in intellectual activities, such as playing chess or Mahjong with others, may be an effective way to reduce physical frailty.

Frequent social engagement might help to decrease the risk of frailty in the Chinese older population. This finding has important implications for public health policy and encourages the incorporation of a broad range of social engagement into the daily lives of older individuals. Specially, encouraging unmarried older adults to engage in intellectual activities, such as playing chess or Mahjong with others, may be an effective way to reduce physical frailty.

This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer.

We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2002 and June 2018 histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 30 Gy, with a daily dose ranging from 1.8 to 3 Gy.

Sixty-one patients were included in this analysis. The study population was predominantly male (72.1%), with a median age of 62 years (range 32-92). The median baseline hemoglobin level was 7.1 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (85.2%). Bleeding control was achieved in 54 (88.5%) patients. The median levels of hemoglobin at 1, 2, and 3 months after completion of radiotherapy were 10.1 g/dL, 10.2 g/dL, and 10.4 g/dL, respectively; these values were significantly different from that before radiotherapy (7.1 g/dL; p < 0.001). The median overall survival was 4.8 months. Among the 54 patients who achieved bleeding control after radiotherapy, 19 (35.2%) experienced re-bleeding during the follow-up period. The median time to re-bleeding was 6.0 months. Multivariate analysis demonstrated that a higher radiation dose (p = 0.007) and additional chemotherapy after radiotherapy (p = 0.004) were significant factors for prolonging the time to re-bleeding.

Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.

Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.

Adams-Oliver syndrome is characterized by the combination of congenital scalp defects and terminal transverse limb defects. In some instances, cardiovascular malformations and orofacial malformations have been observed. Little is written with regards to the anesthetic management and airway concerns of patients with Adams-Oliver syndrome.

A five-year-old female with Adams-Oliver syndrome presented for repeat lower extremity surgery. Airway exam was significant for dysmorphic features, such as hypertelorism, deviated jaw, and retrognathia. Video laryngoscope was utilized for intubation due to the patients retrognathic jaw, cranial deformities, and facial dysmorphism. A vein finder with ultrasound guidance was needed to place the peripheral intravenous line due to her history of difficult intravenous access. Selleck Vismodegib The patient was successfully intubated with slight cricoid pressure applied to direct the endotracheal tube smoothly. Surgery and recovery were both unremarkable.

Due to varying presentations of Adams-Oliver syndrome, anesthetic and airway management considerations should be carefully assessed prior to surgery. Anesthesiologists must take into consideration possible orofacial abnormalities that may make intubation difficult. Amniotic band syndrome and other limb defects could potentially impact intravenous access as well.

Due to varying presentations of Adams-Oliver syndrome, anesthetic and airway management considerations should be carefully assessed prior to surgery. Anesthesiologists must take into consideration possible orofacial abnormalities that may make intubation difficult. Amniotic band syndrome and other limb defects could potentially impact intravenous access as well.

The primary objective was to describe outpatient treatment of epistaxis among different physicians based on a large patient population over a period of 10 years. The secondary objective was to evaluate the value of the practice fee as an instrument of allocation in patients with epistaxis.

Anonymized statutory health insurance data (AOK Lower Saxony) of patients with a diagnosis of epistaxis treated between 2007 and 2016 were examined. Demographic data, accompanying diagnoses, medication and involved medical groups (general practitioners (GP), pediatricians, ear, nose and throat (ENT) specialists or other) were analyzed. Furthermore, we assessed whether the use of specialist groups changed after abolition of the practice fee in 2013.

Epistaxis was responsible for 302,782 cases (160,963 patients). The distribution of cases was slightly in favor of ENT specialists vs. GP (119,170 vs. 110,352). The cases seen by GP and ENT specialists were comparable with regard to age and sex distribution. Hypertension, atrial fibrillation/flutter and an antithrombotic therapy were slightly more common among cases consulting a GP.