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https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#1
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28323335/surgical-guidelines-for-perioperative-management-of-older-adults-what-geriatricians-need-to-know
#2
Jessica L Colburn, Sanjay Mohanty, John R Burton
A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28306138/john-a-hartford-foundation-centers-of-excellence-program-history-impact-and-legacy
#3
David B Reuben, Daniel B Kaplan, Odette van der Willik, Nora O Brien-Suric
The John A. Hartford Foundation (JAHF) created the Centers of Excellence in Geriatric Medicine and Geriatric Psychiatry in 1988 with the goal of establishing academic training environments to increase geriatrics-trained faculty. The initiative identified medical schools with the necessary components for training academic geriatricians. JAHF grants provided the resources to create a cadre of physicians whose research, teaching and practice leads to substantial contributions in geriatrics. Results from two evaluations show that the program has successfully increased geriatrics-prepared faculty who have achieved promotion and institutional retention, success in winning competitive research grants, and positions of leadership...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28302751/impact-of-the-clinical-frailty-scale-on-outcomes-after-transcatheter-aortic-valve-replacement
#4
Tetsuro Shimura, Masanori Yamamoto, Seiji Kano, Ai Kagase, Atsuko Kodama, Yutaka Koyama, Etsuo Tsuchikane, Takahiko Suzuki, Toshiaki Otsuka, Shun Kohsaka, Norio Tada, Futoshi Yamanaka, Toru Naganuma, Motoharu Araki, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida
Background -The semi-quantitative clinical frailty scale (CFS) is a simple tool to assess patient`s frailty and has been shown to correlate with mortality in elderly patients even when evaluated by non-geriatricians. The aim of the current study was to determine the prognostic value of CFS in patients who underwent transcatheter aortic valve replacement (TAVR). Methods -We utilized the Optimized CathEter vAlvular iNtervention (OCEAN) Japanese multicenter registry to review data of 1215 patients who underwent TAVR...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28302066/geriatric-support-in-the-emergency-department-a-national-survey-in-belgium
#5
Els Devriendt, Isabelle De Brauwer, Lies Vandersaenen, Pieter Heeren, Simon Conroy, Benoit Boland, Johan Flamaing, Marc Sabbe, Koen Milisen
BACKGROUND: Older people in the emergency department (ED) represent a growing population and increasing proportion of the workload in the ED. This study investigated the support for frail older people in the ED, by exploring the collaboration between the geriatric services (GS) and the EDs in Belgian hospitals. METHODS: An electronic cross-sectional survey in all Belgian hospitals with an ED (n = 100) about care aspects, collaboration, education and infrastructure for older patients in the ED was collected...
March 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28295142/creation-of-an-interprofessional-teledementia-clinic-for-rural-veterans-preliminary-data
#6
Becky B Powers, Marcia C Homer, Natalia Morone, Natali Edmonds, Michelle I Rossi
The teledementia clinic is a new model of care that expands the reach of specialized geriatric and dementia care using clinical video telehealth (CVT) to rural veterans, who frequently lack access to specialty care. The clinic is a Veterans Affairs (VA) Geriatric Research, Education, and Clinical Center clinical demonstration project. It is located in the Pittsburgh VA Healthcare System tertiary referral hospital and serves veterans in affiliated rural community-based outpatient clinics (CBOCs). Rural CBOC primary care providers refer clinic patients, or referral is according to previous cognitive impairment diagnosis in a VAPHS geriatric clinic...
March 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28292646/follow-up-of-elderly-patients-with-urogenital-cancers-evaluation-of-geriatric-care-needs-and-related-actions
#7
Silvio Monfardini, Sara Morlino, Riccardo Valdagni, Mario Catanzaro, Ardit Tafa, Barbara Bortolato, Giovanni Petralia, Elisa Bonetto, Elisa Villa, Stefano Picozzi, Maria Cristina Locatelli, Giuseppe Galetti, Andrea Millul, Yasmin Albanese, Elisa Bianchi, Claudia Panzarino, Francesca Gerardi, Ettore Beghi
OBJECTIVES: To investigate a comprehensive geriatric assessment (CGA) with subsequent investigation of healthcare patterns in older patients with urological cancers undergoing initial surgery or radiotherapy, to verify the usefulness of the incorporation of geriatric principles in future care plans. MATERIAL AND METHODS: This is a prospective cohort study. From November 2011 to March 2015, CGA was offered to all patients aged 70+ years treated with radiotherapy or surgery at seven tertiary centers...
March 11, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28282071/-new-predictors-in-prodromal-alzheimer-deferred-phase-in-word-recall-of-mis-test
#8
Edith Labos, Sofía Trojanowski, Marcelo Schapira, Daniel Seinhart, Alejandro Renato
BACKGROUND: The Memory Impairment Screen (MIS-A) is a validated test to detect Alzheimer's Disease (AD) and other dementias. We have modified this test to suit a Spanish speaking population and added a new component, delayed recall (MIS-D). OBJECTIVES: 1) To test a Spanish version of MIS-A and MIS-D. 2) To assess the discriminative validity of MIS-D as a screening tool for the amnestic variant of Mild Cognitive Impairment (aMCI). METHODS: A case-control study of a cohort of 739 aged 65 years old and over, of whom 436 were healthy controls and 303 had a diagnosis of aMCI...
September 2016: Vertex: Revista Argentina de Psiquiatriá
https://www.readbyqxmd.com/read/28280606/utility-of-the-edmonton-frail-scale-in-identifying-frail-elderly-patients-during-treatment-of-colorectal-cancer
#9
Brandon M Meyers, Humaid O Al-Shamsi, Sara Rask, Radhika Yelamanchili, Callista M Phillips, Alexandra Papaioannou, Gregory R Pond, Neera Jeyabalan, Kevin M Zbuk, Sukhbinder Kaur Dhesy-Thind
BACKGROUND: Frailty has been proposed by geriatricians as an indicator of functional age. The Edmonton Frail Scale (EFS) is a 15-point incremental scale; it is quick (<5 min), and simple to administer. We conducted an exploratory study to establish if the EFS add utility to clinician's expertise by determining if there was an association between EFS and receipt of chemotherapy in colorectal cancer (CRC) patients. METHODS: The EFS was administered to stage II-IV CRC patients ≥70 years...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28279606/frailty-and-multimorbidity-different-ways-of-thinking-about-geriatrics
#10
Matteo Cesari, Mario Ulises Pérez-Zepeda, Emanuele Marzetti
The terms multimorbidity and frailty are increasingly used in the medical literature to measure the risk profile of an older individual in order to support clinical decisions and design ad hoc interventions. The construct of multimorbidity was initially developed and used in nongeriatric settings. It generates a monodimensional nosological risk profile, grounding its roots in the somewhat inadequate framework of disease. On the other hand, frailty is a geriatric concept that implies a more exhaustive and comprehensive assessment of the individual and his/her environment, facilitating the implementation of multidimensional and tailored interventions...
April 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28266344/epilepsy-at-the-prodromal-stages-of-neurodegenerative-diseases
#11
Benjamin Cretin, Nathalie Philippi, Laure Dibitonto, Frédéric Blanc
This review provides a clinically grounded description of the links between epilepsy and early common neurodegenerative diseases (i.e. Alzheimer's disease, Lewy body disease, vascular cognitive impairment, fronto-temporal lobar degeneration). It shows that epilepsy does not only concern demented patients displaying convulsive seizures (whether focal or generalized) and obvious atrophy on brain imaging. On the contrary, unprovoked seizures and epilepsy - commonly involving the temporal lobe - are now reported at the prodromal stages of these diseases, when cognitive complaints are mild or even minimal and brain imaging inconstantly abnormal...
March 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28265557/modified-delphi-consensus-to-suggest-key-elements-of-stepping-on-falls-prevention-program
#12
Jane E Mahoney, Lindy Clemson, Amy Schlotthauer, Karin A Mack, Terry Shea, Vicki Gobel, Sandy Cech
Falls among older adults result in substantial morbidity and mortality. Community-based programs have been shown to decrease the rate of falls. In 2007, the Centers for Disease Control and Prevention funded a research study to determine how to successfully disseminate the evidence-based fall prevention program (Stepping On) in the community setting. As the first step for this study, a panel of subject matter experts was convened to suggest which parts of the Stepping On fall prevention program were considered key elements, which could not be modified by implementers...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28264119/where-is-the-geriatrician-reply
#13
Julie Bynum, Jeffrey Munson, Anna N A Tosteson
No abstract text is available yet for this article.
March 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28264112/where-is-the-geriatrician
#14
Matteo Cesari, Riccardo Calvani, Emanuele Marzetti
No abstract text is available yet for this article.
March 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28258899/are-future-radiation-oncologists-equipped-with-the-knowledge-to-manage-elderly-patients-with-cancer
#15
Lucinda Morris, Niluja Thiruthaneeswaran, Margot Lehman, Gina Hasselburg, Sandra Turner
PURPOSE: To assess radiation oncology (RO) trainee knowledge, attitudes, and clinical practice relating to geriatric oncology. METHODS AND MATERIALS: A custom online survey was anonymously administered to RO trainees across Australia, New Zealand, and Singapore. The survey assessed 3 domains: (1) trainee demographics and prior training in geriatric medicine; (2) current clinical practice and attitudes regarding elderly cancer patients and radiation therapy; and (3) opinions regarding educational opportunities around geriatric oncology...
January 9, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28236609/accuracy-of-teledentistry-for-diagnosing-dental-pathology-using-direct-examination-as-a-gold-standard-results-of-the-tel-e-dent-study-of-older-adults-living-in-nursing-homes
#16
Alain Queyroux, Bernard Saricassapian, Daniel Herzog, Karin Müller, Isabelle Herafa, Dorothée Ducoux, Benoît Marin, Thierry Dantoine, Pierre-Marie Preux, Achille Tchalla
IMPORTANCE: Dental neglect and high levels of unmet dental needs are becoming increasingly prevalent among elderly residents of long-term care facilities, although frail, elderly, and dependent populations are the most in need of professional dental care. Little is known about the validity of teledentistry for diagnosing dental pathology in nursing home residents. OBJECTIVES: To evaluate the accuracy of teledentistry for diagnosing dental pathology, assessing the rehabilitation status of dental prostheses, and evaluating the chewing ability of older adults living in nursing homes (using direct examination as a gold standard)...
February 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28224518/-oral-anticoagulation-in-the-elderly-the-geriatricians-view
#17
REVIEW
Markus Gosch, Hans Jürgen Heppner, Joachim Zeeh
No abstract text is available yet for this article.
February 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28220380/effectiveness-of-interventions-to-deprescribe-inappropriate-proton-pump-inhibitors-in-older-adults
#18
REVIEW
Tom D Wilsdon, Ivanka Hendrix, Tilenka R J Thynne, Arduino A Mangoni
BACKGROUND: The use of proton pump inhibitors (PPIs) in older adults is high, often inappropriate, and may cause harm. Deprescribing is defined as the reduction, withdrawal, or discontinuation of inappropriate medication. OBJECTIVE: We conducted a systematic review to determine the effectiveness of interventions to deprescribe inappropriate PPIs in older adults. METHODS: We searched MEDLINE, PubMed, Embase, the Cochrane Library, ProQuest Dissertations and Theses Global, and Google from inception to January 2017 for randomized and non-randomized studies describing the outcomes of interventions to deprescribe inappropriate PPIs in older adults (mean or median age of ≥65 years)...
April 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#19
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28209051/melanoma-in-the-elderly
#20
Ausilia M Manganoni, Laura Pizzatti, Laura Pavoni, Francesca Consoli, Enrico Damiani, Giorgio Manca, Giulio Gualdi, Piergiacomo Calzavara-Pinton
BACKGROUND: Among older patients, melanoma in general presents biological features related to a more aggressive biology, such as more locally advanced tumor. Management of melanoma in elderly may be difficult, mainly due to comorbidities. We report the experience of the Melanoma Unit of University Hospital ASST Spedali Civili di Brescia, Italy. METHODS: Study subjects were drawn from 3444 patients with histological confirmed melanoma. Data were extracted from electronic database of the Melanoma Unit of University Hospital ASST Spedali Civili of Brescia, Italy...
February 16, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
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