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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
Can myocarditis heal itself?
Myocarditis is an inflammatory disease of the myocardium. Common causes include viral infections, while bacterial and fungal infections can also cause myocarditis, but these are relatively less common. The onset of myocarditis can vary; it may be rapid, occasionally leading to acute heart failure and sudden cardiac death. However, most cases of myocarditis are self-limiting, though they can also progress to dilated cardiomyopathy. For individuals presenting with flu-like symptoms such as fever, general fatigue, muscle soreness, nausea, and vomiting, or other gastrointestinal issues, it is advisable to provide rest and nutritional support treatment. This is because these cold symptoms might also be indicative of myocarditis. Therefore, general treatment, rest, and nutrition should be emphasized for patients with colds.
How is myocarditis diagnosed?
Myocarditis is an inflammatory disease of the myocardium, which can be confirmed by the following tests: Chest X-rays can show an enlarged cardiac silhouette. Electrocardiograms can reveal changes in the ST-T segments, and various arrhythmias may also occur, especially ventricular arrhythmias and atrioventricular conduction blocks. Echocardiography might be normal, or it might show enlargement of the left ventricle and weakened wall motion. Cardiac MRI is of significant importance for the diagnosis of myocarditis, showing patchy enhancement of the myocardium. Biochemical blood tests can show elevated non-specific inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein, and elevated levels of myocardial enzymes and troponin. Serological testing for viruses can suggest a cause but is not definitive for diagnosis. Finally, endomyocardial biopsy, besides diagnosing, can also aid in assessing the condition and prognosis. However, it is invasive, so it is generally used only in urgent and severe cases, cases with poor treatment response, or in patients with undiagnosed causes. It is not commonly performed in patients with mild conditions.
What are the symptoms of Parkinson's disease?
The main symptoms of Parkinson's disease are divided into two major categories: motor symptoms and non-motor symptoms. The motor symptoms include bradykinesia and hypokinesia, specifically characterized by slow movement speed and reduced amplitude. In daily life, this results in clumsiness with actions such as difficulty standing up, small arm swings while walking, or even no swinging at all, a lack of facial expressions, and progressively smaller handwriting. The second type is resting tremor, which includes pill-rolling movements along with muscle rigidity and postural and gait imbalances, such as a panicked gait or taking very small steps that accelerate and become faster without the ability to stop or turn promptly. Non-motor symptoms include issues such as olfactory dysfunction, sleep disturbances, constipation, and depression.
The causes of Parkinson's disease
Parkinson's disease, also known as tremor paralysis, is a common neurodegenerative disorder. The cause of Parkinson's disease is not yet clear, but it may be related to several factors, such as aging, genetics, and environmental factors. Since Parkinson's disease is the result of multiple factors, including abnormal protein aggregation, oxidative stress, mitochondrial damage, inflammation, and excitotoxicity of glutamate, these elements lead to the loss of dopaminergic neurons in the substantia nigra of the midbrain and a reduction in dopamine neurotransmitters in the striatum. This ultimately results in the patient's bradykinesia, muscle rigidity, and resting tremor.
Methods of Diagnosing Parkinson's Disease
In the auxiliary examinations for Parkinson's disease, routine laboratory tests as well as CT and MRI scans of the head generally show no specific changes. However, in molecular imaging, PET CT can reveal a significant decrease in striatal dopamine transporter. For olfactory tests, over 80% of Parkinson's patients exhibit olfactory dysfunction. Doppler ultrasound can also detect a significant enhancement of the substantia nigra signal. Despite these advancements in auxiliary examinations, diagnosis in patients with Parkinson's disease still primarily relies on clinical evaluation. According to the 2015 criteria, the diagnostic standards are still based on clinical diagnosis, which includes two main points: first, bradykinesia, where voluntary movements are slow and the speed and amplitude of repetitive movements progressively decrease; second, at least one of the following two manifestations must be present: muscular rigidity or resting tremor.
How to Cure Geriatric Depression
For geriatric depression, the treatment includes several aspects. Firstly, it is important to strengthen the patient's diet and nutrition supplementation. Secondly, certain psychological therapies should be provided to the depressed patients. The aim is mainly to alleviate or relieve symptoms, improve patients’ compliance with medication, prevent relapse, and reduce or eliminate the adverse consequences caused by the disease. The third aspect is to provide certain medication treatments, such as the currently used selective serotonin reuptake inhibitors (SSRIs), and selective norepinephrine reuptake inhibitors (SNRIs). These types of medications have been widely used in patients with geriatric depression disorders. Among them, SSRIs are quite effective for geriatric depression disorders and can effectively counteract cholinergic and have milder adverse reactions on the cardiovascular system, making it easy for elderly patients to accept and maintain long-term treatment. The fourth aspect is the improvement of electroconvulsive therapy, which can significantly improve depression when combined with comprehensive treatment. However, since depression has a high recurrence rate, full-course treatment is recommended.
What causes urinary incontinence in the elderly?
Urinary incontinence in the elderly varies due to different mechanisms and types, with the two most common categories being genuine urinary incontinence, which is due to neurogenic bladder dysfunction or overactive detrusor muscles, damage to the urethral sphincter, or loss of bladder storage function. These are commonly seen in conditions like chronic stroke, dementia, Parkinson's disease, and psychiatric diseases. The other major category is caused by relaxation of the urethral sphincter or pelvic floor muscles surrounding the urethra, leading to reduced urethral pressure. Incontinence in this category may occur when negative pressure increases, such as during coughing, sneezing, straining during bowel movements, or changing body position. This type of urinary incontinence is more common in elderly women and in elderly men who have had prostate removal, leading to damage to the external urethral sphincter.
Is myocarditis serious?
Myocarditis is an inflammatory disease of the myocardium, most commonly caused by viral infections. The onset of the disease can be either sudden or slow, and it is mostly self-limiting, but in rare cases can lead to acute pump failure or sudden death. The severity of the condition largely depends on the extent and location of the lesions. Mild cases may have no symptoms at all, while severe cases can lead to cardiogenic shock or even sudden death. In clinical diagnosis, the majority of myocarditis cases present primarily with arrhythmias, and in a minority of cases, the initial symptoms may include syncope or Adams-Stokes syndrome. Thus, the severity of myocarditis is related to the variation in the condition itself.
How long does the course of Parkinson's disease usually last?
The course of Parkinson's disease generally lasts for how long? Parkinson's disease, also known as shaking palsy, is a common neurodegenerative disease, and the age at onset varies. For early-onset Parkinson's disease, it generally starts around age 40 to 50, while late-onset Parkinson's disease generally starts after age 50. As age gradually increases, the course of Parkinson's disease is generally about 20 to 40 years. Once diagnosed with Parkinson's disease, it is a lifelong condition. This disease is incurable, and can only be managed through medications, surgical treatments, physical rehabilitation, and psychological therapies to improve or control symptoms, but it cannot be cured. Therefore, once diagnosed with Parkinson's disease, the disease is lifelong.
Myocarditis is what?
Myocarditis is an inflammatory disease of the myocardium, primarily caused by viral infections. Typically, signs of infection such as fever, generalized fatigue, muscle soreness, or gastrointestinal symptoms like nausea and vomiting appear one to three weeks before the onset of myocarditis. Patients may experience palpitations, chest tightness, difficulty breathing, edema, and even fainting or sudden death. Clinically, viral myocarditis is mostly diagnosed due to arrhythmias as the main complaint or primary symptom, and in rare cases, it can lead to fainting or Aschoff's syndrome. For patients with myocarditis, timely examinations like myocardial enzymes, troponins, electrocardiograms, echocardiography, and cardiac MRI are crucial to confirm the diagnosis. Appropriate treatment should be administered to prevent the myocarditis from progressing to cardiac arrest or heart failure.