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John Dabis, Aliyah Hussein, Mark Rickman
Hip fractures represent a significant burden to the NHS: the cost for all UK hip fractures is approximately £2 billion and in 2013, 64 838 people were admitted to hospital with a fractured neck of femur (FNOF). In April 2010 St George's NHS Hospital was designated one of four Major Trauma Centres (MTC) in London. Following MTC designation, in April 2014 St George's Hospital opened a helipad. This study aimed to assess the impact of the helipad designation on the Trust's ability to meet the Best Practice Tariff (BPT) criteria for FNOF patients...
October 18, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Ronald J Maggiore, Kathryn E Callahan, Janet A Tooze, Ira R Parker, Tina Hsu, Heidi D Klepin
The number of older adults with cancer is growing, necessitating more collaborative training in both geriatric principles and cancer care. We administered a web-based survey to U.S. geriatrics program directors (PDs) addressing cancer-specific training and perspectives on optimal training content and roles for geriatricians in cancer care. Of 140 PDs contacted, 67 (48%) responded. Topics considered very important in training included cancer screening (79%) and cancer-related pain management (70%). Respondents strongly agreed that some of the geriatrician's roles in cancer care included assessing functional status (64%) and assessing physical/cognitive function for goals of care (64%)...
October 17, 2016: Gerontology & Geriatrics Education
Andreas Stuck
No abstract text is available yet for this article.
2016: Swiss Medical Weekly
Lee A Lindquist, Rachel K Miller, Wayne S Saltsman, Jennifer Carnahan, Theresa A Rowe, Alicia I Arbaje, Nicole Werner, Kenneth Boockvar, Karl Steinberg, Shahla Baharlou
We assembled a cross-cutting team of experts representing primary care physicians (PCPs), home care physicians, physicians who see patients in skilled nursing facilities (SNF physicians), skilled nursing facility medical directors, human factors engineers, transitional care researchers, geriatricians, internists, family practitioners, and three major organizations: AMDA, SGIM, and AGS. This work was sponsored through a grant from the Association of Subspecialty Physicians (ASP). Members of the team mapped the process of discharging patients from a skilled nursing facility into the community and subsequent care of their outpatient PCP...
October 4, 2016: Journal of General Internal Medicine
M Wehling, C Ashton, E Ekpo, S Gwynn, M Laville, K Olsson, M Spring
Introduction: Causes of hyponatraemia in older patients are multivariate and in the case of SIADH may often be drug induced. Diagnostic and treatment algorithms are unclear for this important age group. Methods: The author group identified 6 broad themes for consensus and formulated 42 separate consensus statements within these 6 themes. Statements were then circulated to geriatricians, general practitioners and other doctors to test agreement at the European level. Results: 64 responses were evaluated from around Europe...
October 4, 2016: Drug Research
Frank J Infurna, Morris A Okun, Kevin J Grimm
OBJECTIVES: To examine whether psychosocial factors that can be a target for interventions, such as volunteering, are associated with risk of cognitive impairment. DESIGN: Health and Retirement Study (HRS) data from 1998 to 2012, a nationally representative longitudinal panel survey of older adults assessed every 2 years, were used. SETTING: The HRS interviews participants aged 50 and older across the contiguous United States. PARTICIPANTS: Individuals aged 60 and older in 1998 (N = 13,262)...
October 3, 2016: Journal of the American Geriatrics Society
Annemarie de Vos, Jane-Murray Cramm, Jeroen D H van Wijngaarden, Ton J E M Bakker, Johan P Mackenbach, Anna P Nieboer
BACKGROUND: The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital-related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2-0.6]), lower depression (Geriatric Depression Scale 15; -0...
September 29, 2016: International Journal of Health Planning and Management
Bertrand Glize, Étienne Santos, Sophie Broussy, Igor Sibon, Pierre-Alain Joseph, Patrick Dehail
OBJECTIVE: Post-stroke medical management, defined by national and international guidelines, involves many professionals, allowing optimal secondary prevention. The general practitioner is as a major player in this management. The improved of this management appears as the new challenge following the stroke Plan 2009-2014. The aim of this study was to evaluate the medical and paramedical management of patients in the year following a stroke. MATERIAL/PATIENTS AND METHODS: This was an observational study among general practitioners of stroke patients in Aquitaine...
September 2016: Annals of Physical and Rehabilitation Medicine
Aurélien Dinh, Benjamin Davido, Jérôme Salomon, Jean-Laurent Le Quintrec, Laurent Teillet
Due to the high risk of infection, the geriatric population is regularly subjected to antibiotics. Faced with bacterial resistance, particularly among elderly dependent patients, it is essential to promote proper use and correct prescription of antibiotics. A study evaluated antibiotic prescription in a geriatric hospital with 598 beds and highlighted the importance of collaboration between geriatricians and infectious disease specialists.
September 2016: Soins. Gérontologie
Martin Ritt, Karl-Günter Gaßmann, Cornel Christian Sieber
Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
Denise J C Hanssen, Peter L B J Lucassen, Peter H Hilderink, Paul Naarding, Richard C Oude Voshaar
OBJECTIVE: Research on health-related quality of life (HRQoL) in older persons with medically unexplained symptoms (MUS) is scarce, and, in contrast with younger patients, interactions with chronic somatic diseases are more complex. DESIGN: In the current study we compared HRQoL between older persons with MUS and older persons with medically explained symptoms (MES). Our study sample consisted of 118 older MUS-patients and 154 older MES-patients. SETTING/MEASUREMENTS: The diagnosis of MUS was ascertained by the general practitioner and confirmed by a geriatrician within a multidisciplinary diagnostic assessment...
November 2016: American Journal of Geriatric Psychiatry
Allison Magnuson, Beverly Canin, G J van Londen, Beatrice Edwards, Pamela Bakalarski, Ira Parker
A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum...
November 2016: Current Oncology Reports
Jacqui Thornton
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
Emily Cooper, Karen Spilsbury, Dorothy McCaughan, Carl Thompson, Tony Butterworth, Barbara Hanratty
OBJECTIVE: to establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. DESIGN: two-stage, online modified Delphi study. SETTING AND PARTICIPANTS: a panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education...
September 8, 2016: Age and Ageing
M Schuers, M Timsit, A Gillibert, A Fred, N Griffon, J Bénichou, S J Darmoni, P Staccini
BACKGROUND: To evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record. METHODS: An e-mailed self-administered questionnaire was sent to all the pharmacists, anaesthesiologists, geriatricians and emergency physicians of the 55 hospitals involved in the patient pharmaceutical record experimentation...
September 2016: Revue D'épidémiologie et de Santé Publique
Benoit Cossette, Josée Bergeron, Geneviève Ricard, Jean-François Éthier, Thomas Joly-Mischlich, Mitchell Levine, Modou Sene, Louise Mallet, Luc Lanthier, Hélène Payette, Marie-Claude Rodrigue, Serge Brazeau
OBJECTIVES: To evaluate the effect of a knowledge translation (KT) strategy to reduce potentially inappropriate medication (PIM) use in elderly inpatients in the hospital. DESIGN: Segmented regression analysis of an interrupted time series. SETTING: Teaching hospital. PARTICIPANTS: Individuals aged 75 and older discharged from the hospital in 2013/14 (mean age 83.3, 54.5% female). INTERVENTION: The KT strategy comprises the distribution of educational materials, presentations by geriatricians, pharmacist-physician interventions based on alerts from a computerized alert system, and comprehensive geriatric assessments...
September 2, 2016: Journal of the American Geriatrics Society
Luca Pasina, Sarah Astuto, Laura Cortesi, Mauro Tettamanti, Carlotta Franchi, Alessandra Marengoni, Pier Mannuccio Mannucci, Alessandro Nobili
BACKGROUND: Explicit criteria for potentially inappropriate prescriptions in the elderly are recommended to avoid prescriptions of duplicate drug classes and to optimize monotherapy within a single drug class before a new agent is considered. Duplicate drug class prescription (or therapeutic duplicates) puts the patient at increased risk of adverse drug reactions with no additional therapeutic benefits. To our knowledge, the prevalence of elderly inpatients receiving therapeutic duplicates has never been studied...
September 2016: Drugs & Aging
C Stadler, M Gosch, T Roth, C Neuerburg, C Kammerlander
BACKGROUND: The treatment of geriatric patients in the field of trauma surgery is increasingly gaining importance. To provide optimized treatment to these mostly multimorbid patients, interdisciplinary treatment concepts between trauma surgeons and geriatricians have been designed and implemented successfully. OBJECTIVES: The aim of this survey was to evaluate the current state of interdisciplinary management in the treatment of geriatric patients on trauma surgery wards throughout Austria...
August 30, 2016: Der Unfallchirurg
Stijn L Steunenberg, Alexander Te Slaa, Gwan H Ho, Eelco J Veen, Hans G W de Groot, Lijckle van der Laan
BACKGROUND: Critical limb ischemia (CLI) is a disease that is most prevalent in the elderly population. This group of patients includes patients suffering from comorbidities such as dementia. Mortality rates of both CLI and dementia are higher when compared with the nonaffected population. These demented vascular patients are often deemed unfit for surgery and at risk of respiratory and cardiovascular adverse events. Unfortunately, current literature is lacking in to determining the optimal treatment for demented patients suffering from CLI...
August 27, 2016: Annals of Vascular Surgery
Angélique Brunot, Samuel Le Sourd, Marc Pracht, Julien Edeline
Hepatocellular carcinoma (HCC) is the second most common cause of death by cancer in the world. Due to the delayed HCC development in hepatitis C carriers and nonalcoholic fatty liver disease, the incidence of HCC in the elderly is increasing and is becoming a global health issue. Elderly patients with HCC should be assessed through proper oncologic approach, namely, screening tools for frailty (Geriatric-8 or Vulnerable Elders Survey-13) and comprehensive geriatric assessment. This review of the literature supports the same treatment options for elderly patients as for younger patients, in elderly patients selected as fit following proper oncogeriatric assessment...
2016: J Hepatocell Carcinoma
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