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Zhou Yan
Geriatrics
About me
Member of the 7th Rehabilitation Professional Committee of the Chinese Society of Rehabilitation Medicine, and Chairman of the 1st Youth Committee of the Geriatric Health Medical Professional Committee of the Hunan Provincial Women Physicians Association.
Proficient in diseases
Specializes in geriatric internal medicine diseases, particularly in the rescue of cardiovascular critical illnesses such as acute coronary syndrome, hypertensive crisis, malignant arrhythmia, acute heart failure, etc.
Voices
Does Parkinson's disease cause dizziness?
For patients with Parkinson's disease, the clinical symptoms are mainly divided into two categories: motor symptoms and non-motor symptoms. Among the non-motor symptoms, dysfunctions in autonomic nervous regulation can manifest as orthostatic hypotension, which generally occurs in the middle to late stages of Parkinson's disease. The main manifestation is a continuous drop in systolic blood pressure by more than 30mmHg, or diastolic blood pressure by more than 15mmHg within three minutes of the patient moving from a lying or sitting position to a standing position. This can lead to general fatigue, dizziness or light-headedness, slow thinking, and even fainting. Therefore, when patients with Parkinson’s disease experience dizziness, it is important to consider the possibility of orthostatic hypotension.
Do elderly people with urinary incontinence have catheters?
Elderly people with urinary incontinence do not need a catheter. Urinary incontinence refers to the uncontrolled flow of urine from the urethra, independent of conscious control. There are many causes of urinary incontinence, but none require catheterization for urine drainage. Catheterization is only necessary when urine cannot be expelled, such as in cases of chronic urinary retention caused by an enlarged prostate, where the bladder pressure exceeds the resistance of the urethral sphincter. Other types of urinary incontinence do not require the use of a catheter for urination; instead, treatment should be based on the specific cause of the incontinence.
What causes urinary incontinence in the elderly?
Urinary incontinence in the elderly refers to individuals over the age of 60 who experience involuntary urine leakage from the urethra, beyond their subjective control. Based on different mechanisms of onset, there are four main types: genuine urinary incontinence, stress urinary incontinence, overflow urinary incontinence, and urge urinary incontinence. Persistent urinary incontinence is due to neurogenic bladder dysfunction, excessive contraction of the urinary muscles, severe damage to the urethral sphincter, and the bladder losing its storage function. This type can be seen in conditions like chronic stroke, dementia, Parkinson's disease, and spinal disease. Stress urinary incontinence occurs due to relaxation of the urethral sphincter, pelvic floor muscles, and muscles around the urethra, leading to reduced urethral pressure. This situation is more common in elderly women and in the perineum of men, or due to urethral damage and urethral surgery. The third major category is overflow urinary incontinence, mainly seen in obstructive lower urinary tract diseases such as prostatic hyperplasia. Chronic urinary retention due to various causes results in bladder pressure exceeding the resistance of the normal urethral sphincter, causing urine to leak from the urethra. Lastly, urge urinary incontinence generally refers to overactivity of the bladder muscles, typically associated with bladder inflammation, acute urethritis, or the presence of bladder stones, bladder tumors, or obstructions at the bladder outlet, all of which can cause urge urinary incontinence.
What tests are done for myocarditis?
First is the electrocardiogram, which can show STT changes, including mild ST segment shift and T wave inversion, and various arrhythmias, especially ventricular arrhythmias and atrioventricular conduction blocks. Next is the cardiac ultrasound, also known as echocardiography, which can be normal or show left ventricular enlargement, reduced left ventricular motion, and decreased left ventricular systolic function. Another method is cardiac MRI, which mainly shows evidence of cardiac damage, and this has significant implications for the diagnosis of myocardial conditions. Additionally, biochemical tests include elevated cardiac enzymes, troponin, accelerated erythrocyte sedimentation rate, and other non-specific inflammatory markers. Moreover, there is cardiac biopsy, which is generally invasive and thus mainly used in patients with severe conditions, poor treatment response, or unknown causes. This test is generally not used in patients with mild symptoms. Other tests include chest X-rays and etiological examinations.
Can acute heart failure be fatal?
The answer is affirmative. Acute heart failure is a very dangerous and serious clinical syndrome in cardiovascular diseases. Generally speaking, it is characterized by a significant decrease in the cardiac contractile function and an increased cardiac load, leading to a sharp drop in acute cardiac output, a sudden increase in pulmonary circulation pressure, and increased resistance in peripheral circulation. This results in acute pulmonary congestion and pulmonary edema and may be accompanied by insufficient perfusion of tissues and organs and a clinical syndrome of cardiogenic shock. Therefore, it can be fatal, and if not addressed promptly or adequately, it often has a high mortality rate.
What is the best treatment for myocarditis?
Myocarditis currently has no specific treatment and mainly focuses on supportive treatment for left ventricular dysfunction. Patients should avoid exertion and rest appropriately. In cases of heart failure, diuretics, vasodilators, and other drugs such as H1 may be used as needed. If rapid arrhythmias occur, antiarrhythmic drugs should be administered. For high-degree atrioventricular block or sinoatrial node dysfunction that causes syncope or significant hypotension, the use of a temporary pacemaker may be considered. Moreover, clinically, drugs that promote myocardial metabolism, such as adenosine triphosphate, coenzyme A, adenylic acid, etc., should be used. Treatment should also target the underlying causes of myocarditis.
Can people with Parkinson's disease eat honey?
Parkinson's disease, also known as paralysis agitans, is a common neurodegenerative disease of the nervous system. Clinically, it is primarily characterized by symptoms such as bradykinesia, muscle rigidity, and resting tremors, as well as non-motor symptoms such as loss of smell. Patients with paralysis agitans also experience autonomic dysfunction, commonly manifesting as constipation due to slowed intestinal peristalsis. These symptoms can appear 10 to 20 years before the motor symptoms and may include lack of appetite, nausea, vomiting, and increased salivation. For patients with paralysis agitans, consuming honey is beneficial as it can help alleviate constipation by softening the stool and facilitating bowel movements, due to the reduced intestinal motility.
Is massage effective for Parkinson's disease?
The treatment of Parkinson's disease is comprehensive, with medication being the core method. Surgical treatments can supplement medication, and it is also important to include physical rehabilitation and psychological therapy. When patients have their symptoms and signs controlled by medication, massage can be administered to enhance their motor abilities and coordination, improving symptoms and slowing the progression of the disease. Massage therapy, therefore, has proven to be somewhat effective in this respect.
How to treat geriatric depression effectively?
Elderly depression should be treated comprehensively. Firstly, it is important to enhance the diet and supplement nutrition. Secondly, through psychotherapy, mainly to alleviate or relieve symptoms, improve patients' compliance with drug treatment, and reduce or eliminate the adverse consequences of the disease. Thirdly, pharmacotherapy can involve the use of selective serotonin reuptake inhibitors, selective serotonin, and norepinephrine reuptake inhibitors, which are widely used in the treatment of elderly patients with depression. Fourth, modified electroconvulsive therapy is an option. Through the aforementioned comprehensive treatment, the clinical symptoms of depression can be improved. (Medication should be used under the guidance of a physician.)
Early symptoms of Parkinson's disease
The clinical manifestations of Parkinson's disease are divided into two major categories. One category includes motor symptoms related to damage to the dopaminergic system. The other category includes non-motor symptoms related to damage to non-dopaminergic systems. The non-motor symptoms of Parkinson's disease can appear at various stages, especially before the onset of motor symptoms, such as loss of smell, rapid eye movement sleep behavior disorder, constipation, and depression, which are often early symptoms of the disease. However, because the onset of the disease in patients is relatively hidden, the initial symptoms are often tremors, but can also be bradykinesia or stiffness, with the majority of these cases being diagnosed based on these symptoms. Therefore, when a patient has loss of smell, constipation, depression, or sleep behavior disorder, the possibility of Parkinson's tremor paralysis should be considered.