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Biomedical subjects

A Abyad

Publications and source records attributed to A Abyad.

At least 19 recordsLinked to original sources
PubMed2002

Prevalence of vitamin B12 deficiency among demented patients and cognitive recovery with cobalamin replacement.

OBJECTIVE: To find out the prevalence of vitamin B12 deficiency among demented patients and to look at the effects of cobalamin repletion on cognition in elderly, subjects with low serum cobalamin and evidence of cognitive dysfunction. DESIGN: Time series data collected in a single-blinded trial of parenteral cobalamin therapy. SETTINGS: Nursing home facility and Outpatient geriatric assessment center. PARTICIPANTS: Sixty-two subjects with low serum cobalamin (<300 pg/ml) and evidence of cognitive dysfunction were entered consecutively over a two years period of time. Fifty-six subjects completed the study. INTERVENTIONS: Subjects received 1000 micrograms of cyanocobalamin intramuscularly daily for 1 week, then weekly for 1 month, then monthly thereafter for a minimum of six months. OUTPATIENT MEASURE: The Folstein Minimental Status Examination(MMSE), clock drawing tests, and caregiver interviews were administered both before and at 3 months after full cobalamin replacement therapy. Assessment was repeated thereafter every three months. The hypothesis that cognitive improvement was dependent on the duration of cognitive symptoms. RESULTS: After a minimum of 12 months of cobalamin therapy, 40 of 56 patients revealed cognitive improvement. There was a prominent correlation between duration of cognitive symptoms and response to therapy. Patients symptomatic for <12 months gained an average of six points on the MMSE (paired t test P = 0.0065), whereas patients symptomatic >12 months gained an average of four points (paired t test P = 0.25). Six patients symptomatic for only 3 to six months normalized their MMSE scores, gaining 1,2,3, 6, and 9 points, respectively. CONCLUSION: It seems that there may be a time-limited window of opportunity for effective intervention in patients with cognitive dysfunction and low serum cobalamin.

Aged↗
PubMed2001

Health care for older persons: a country profile--Lebanon.

Lebanon is a small country, comparable in size to New Hampshire. It is currently estimated that 8% of the population is age 65 and older. The Lebanese population has witnessed a clear demographic transition in the past few decades. Our culture demands respect for older people and values highly the natural bonds of affection between all members of the family. The healthcare system in the country is an adaptation of the European model. Despite the large number of physicians (approximately 10,000) there is a shortage of primary care and geriatric physicians. There are 36 nursing homes in Lebanon, with a total of 6,000 beds, but most of them are understaffed, with the exception of three nursing homes that offer relatively comprehensive services including rehabilitative, preventive, and curative services. The Ain Wizen Elderly Care Centre is well recognized for the program it operates for older people, which is a good model for the region and for Lebanon in terms of services, training, and research. Demographic changes and social and economic developments in Lebanon have created new realities in the unprecedented growth of the older population. Lebanon, like other developing countries, needs to define the policies and programs that will reduce the burden of an aging population on its society and economy. There is a need to ensure the availability of health and social services for older persons and to promote older persons' continuing participation in a socially and economically productive life.

Aged↗
PubMed1998

House calls in Lebanon: reflections on personal experience.

BACKGROUND: Home health services play an important role in decreasing hospital admissions and physicians' medical house calls play an integral role in home health services. There is no national survey of physicians' house call practice in the Lebanon. OBJECTIVES: The aim of this study was to provide some information about house call practice in the Lebanon. METHOD: Data on patients examined during house call visits between 1 January and the end of December 1995 were reviewed. RESULTS: During this period, 137 patients were seen at their home. Eighty-four patients (62%) were female and 53 patients (38%) were male. Ages ranged from 1 to 85 years. The number of cases seen in 1 month averaged 11. The diagnosis differed according to the age group of patients examined. Most of the house call visits occurred between 6.30 p.m. to 12.00 p.m. (47%). Fifteen patients (11%) were admitted to the hospital. CONCLUSION: The rate of cases per month was similar to those reported elsewhere. Physicians might feel reluctant to conduct house calls out of hours. Our study revealed that the majority of patients were seen between 6 p.m. and 12 p.m., and only 6% were seen after 12 a.m. It is our belief that house calls are an integral part of family practice and need to be stressed during the internships of all primary care physicians.

Adolescent↗
PubMed1997

In-office screening for age-related hearing and vision loss.

Impairment in hearing and vision are common for persons age 65 and older, and severe impairments may result in dependencies in daily activities. Hearing loss with age often results in diminished ability to communicate with others and may lead to isolation, depression, and cognitive changes. A hearing evaluation involving simple screening tools in important for early recognition and treatment of otologic conditions. Cataracts, macular degeneration, diabetic retinopathy, and glaucoma are the most sight-threatening ocular diseases of aging. Visual loss usually occurs gradually and may go unrecognised for some time. Primary care screening is important to preserve sight and prevent disability and loss of function.

Aged↗
PubMed1996

Constipation: common-sense care of the older patient.

Constipation is a common complaint in older patients. Contributing factors are impaired general health, use of medications, and decreased mobility and physical activity. Diet has an indeterminate effect. Many patients become gradually more constipated with age and self-treat with over-the-counter laxatives. Investigation is warranted if defecation is associated with pain or bloating and/or represents a recent change in bowel habit. Although constipation is usually just an annoyance, it can have more serious consequences, such as impaction and ulceration. A combination of bowel training, dietary management, and regular exercise is the first phase of treatment. Bulk laxatives are second-line treatment, followed by other laxatives if needed.

Aged↗
PubMed1995

Literacy and performance on the Mini-Mental State Examination.

OBJECTIVE: Mini-Mental State Examination (MMSE) scores are associated with age, education, and ethnicity. The objective of this research was to determine the relationship between MMSE and literacy. DESIGN: Cross-sectional. SETTING: A Community population in Tucson, Arizona. PARTICIPANTS: Senior citizens in public assistance housing. MEASUREMENTS: MMSE score, reading level, and sociodemographic variables. MAIN RESULTS: A total of 214 subjects were tested. The mean age was 72.3 (+/- 8.01), and the mean education level was 10.3 years (range 0-20 years). Reading levels ranged from grade 0 (non-reader) to 8 (maximum value for the test used). with a mean of 4.8 (+/- 2.8). MMSE scores ranged from a mean of 21.9 (+/- 4.6) for non-readers to a mean of 28.0 (+/- 2.0) for subjects with > or = 8th grade reading skills. Multiple regression using reading level, education, age, and ethnicity as independent variables, and MMSE score as the dependent variable, showed the highest correlation was between MMSE and reading level (R2 = .265). Education level made only a small additional contribution; age and ethnicity did not enter the regression equation. Correlations between reading level and individual MMSE subsections were highest between reading level and MMSE language items (r = .499). CONCLUSIONS: The correlation between MMSE score and reading skills is stronger than the correlation with other sociodemographic variables. Proper interpretation of MMSE scores requires knowledge of patients' reading levels.

Aged↗
PubMed1995

Geriatrics in Lebanon: the beginning.

In Lebanon, it is estimated that 5.4 percent of the population is above sixty-five years of age. This percentage is expected to increase with improvement of the health care delivery in the country. The Lebanese health care system and the role of the American University of Beirut is discussed. Lebanon, like other developing countries, needs to define the policies and programs that will reduce the burden of aging populations on the society and its economy. There is a need to ensure the availability of health and social services for older persons and promote their continuing participation in a socially and economically productive life. The morbidity burden of the geriatric population can quickly overwhelm fragile and underfinanced health infrastructures which are unable to meet fully the prevention and treatment needs of a younger population with relatively low-cost, easy-to-prevent, easy-to-treat illnesses.

Age Distribution↗
PubMed1994

The hospice movement: growth as an alternative, not integrated movement.

The hospice was originally a rest place for travelers. Today, hospice care refers to care for the terminally ill and their families. Hospice care has evolved in the last 30 years; it now comprises an array of services, including home care, special hospital programs, and new autonomous hospices--to care for the terminally ill. The author discusses the beginnings of hospice care and addresses the rapid progression of this model of long-term care delivery.

Forecasting↗
PubMed1992

The general practitioner in Lebanon: is he a potential family physician?

A cross-sectional exploratory study was conducted on a group of general practitioners in Beirut, Lebanon to assess the level of family medicine practice among them. Data were collected on the age, sex, number of children, marital status, load of patients per day, field of specialization, if any, and place of study of medicine of 43 general practitioners. The level of family medicine practice was assessed through a self-administered questionnaire containing questions related to the various criteria of family medicine practice. Only 2.3% of the general practitioners had an adequate level of family medicine practice, defined as the top 15th percentile of a maximal score. Doctors were most likely to adhere to the 'informality' criterion and less likely to adhere to the 'family approach', 'ensuring maximal compliance' and 'comprehensiveness of care' criteria. They performed poorly on 'the continuity of care' and on 'the art of medical care' criteria. Overall, family medicine was found not to be adequately practised by the general practitioner and is deemed necessary as a specialty in Lebanon. Suggestions and future recommendations are further presented.

Adult↗