[Recommendations for the prevention, diagnosis, and therapy of addiction in the elderly]. / Recommandations pour la prévention, le diagnostic et la thérapie des addictions à l'âge avancé.

In old age, the chronic use of substances such as alcohol and sedatives, and more recently opioids, is a major public health and personal problem. Despite this, relatively little attention has been paid to the disorders associated with the use of these substances. These recommendations have been formulated by the Swiss Society for Elderly Psychiatry and Psychotherapy (SPPA) in collaboration with the Swiss Nurses' Association (SNA) and the Swiss Society for Addiction Medicine (SSAM). They provide a summary of the knowledge about addiction disorders in old age for the benefit of those working with patients, with the aim of strengthening prevention, early detection and appropriate interventions.

À l'âge avancé, la consommation chronique de substances comme l'alcool et les sédatifs, et plus récemment les opioïdes, représente un important problème pour les personnes concernées et de santé publique. Malgré cela, relativement peu d'attention a été accordée aux troubles associés à la consommation de ces substances. Les présentes recommandations ont été formulées par la Société suisse de psychiatrie et psychothérapie de la personne âgée (SPPA) en collaboration avec l'Association suisse des infirmières et infirmiers (ASI) et la Société suisse de médecine de l'addiction (SSMA). Elles mettent à la disposition des intervenants auprès des patients un résumé des connaissances au sujet des troubles addictifs à l'âge avancé, avec comme objectif de renforcer la prévention et le dépistage précoce, et des interventions adaptées.

[Recommendations for the Prevention, Diagnostics and Therapy of Addiction Disorders in the Elderly]. / Empfehlungen für die Prävention, Diagnostik und Therapie der Abhängigkeitserkrankungen im Alter.

Recommendations for the Prevention, Diagnostics and Therapy of Addiction Disorders in the Elderly Abstract. Although the chronic consumption of alcohol and sedatives, and increasingly opioids, represents a major problem in old age with consequential damage for those affected, little attention has been paid to the substance abuse disorders in old age. The aim of the present recommendations, a collaboration work of the Swiss Society for Geriatric Psychiatry and Psychotherapy (SGAP), Swiss Nurses Association (SBK) and Swiss Society of Addiction Medicine (SSAM), is to summarize the current state of knowledge in prevention, diagnostics and therapy of substance abuse disorders in old age for an interprofessional clinical team. They are intended to help strengthen prevention and early diagnosis, and consciously emphasize psychotherapy and nursing intervention options.

Interface abrasion between rough surface femoral stems and PMMA cement results in extreme wear volumes--a retrieval study and failure analysis.

During the loosening cascade of cemented rough femoral stems, the destruction of the mantle and the production of cement and metal wear debris occur after the loss of constraint at the interface. Two-dimensional (2D) measurements (light microscopy based morphometry on fragments of mantles and vertical scanning interferometry of femoral stems) permitted mathematical 3D-extrapolations to estimate the wear volumes. Fragments of the cement mantles available lost volumes from 0.85 mm(3) to 494.10 mm(3) (median amount of bone cement wear = 178,426 mg). The harder metal surfaces lost between 1.459 mm(3) and 5.688 mm(3) of material (the median amount of metal wear per surface = 1.504 mg/100 mm(2)). Compared to the loss of material due to the fretting of stems, the abrasion of metal, and cement in defective cement mantles produced wear volumes sufficiently high to induce osteolysis. Though the design of the femoral stem and the handling of bone cement do not represent contemporary design and clinical practice, respectively, an extremely high number of joint replacements still in daily use may be impacted by this study because of possible predicted failures. Once the processes of fragmentation, abrasion, and osteolysis have been realized, the time until revision surgery should not be unduly prolonged.