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Robin Fackrell, Camille B Carroll, Donald G Grosset, Biju Mohamed, Prashanth Reddy, Miriam Parry, Kallol Ray Chaudhuri, Tom Foltynie
In the past 4 years, two adjunctive treatment options to levodopa have been licensed for use in the UK in patients with Parkinson's disease (PD) and motor fluctuations: opicapone, a third-generation catechol-O-methyl transferase inhibitor, and safinamide, a monoamine oxidase B inhibitor. This clinical consensus outlines the practical considerations relating to motor fluctuations and managing wearing-off in patients with PD, and provides a clinical insight to adjunctive treatment options, including opicapone and safinamide...
July 5, 2018: Neurodegenerative Disease Management
Jay G Berry, Sarah D Berry
No abstract text is available yet for this article.
July 2, 2018: JAMA Pediatrics
Ruth Piers, Gwenda Albers, Joni Gilissen, Jan De Lepeleire, Jan Steyaert, Wouter Van Mechelen, Els Steeman, Let Dillen, Paul Vanden Berghe, Lieve Van den Block
BACKGROUND: Advance care planning (ACP) is a continuous, dynamic process of reflection and dialogue between an individual, those close to them and their healthcare professionals, concerning the individual's preferences and values concerning future treatment and care, including end-of-life care. Despite universal recognition of the importance of ACP for people with dementia, who gradually lose their ability to make informed decisions themselves, ACP still only happens infrequently, and evidence-based recommendations on when and how to perform this complex process are lacking...
June 21, 2018: BMC Palliative Care
C Kenis, L Decoster, J Flamaing, P R Debruyne, I De Groof, C Focan, F Cornelis, V Verschaeve, C Bachmann, D Bron, S Luce, G Debugne, H Van den Bulck, J-C Goeminne, D Schrijvers, K Geboers, B Petit, C Langenaeken, R Van Rijswijk, P Specenier, G Jerusalem, J-P Praet, K Vandenborre, J-P Lobelle, M Lycke, K Milisen, H Wildiers
Background: In the general older population, geriatric assessment (GA)-guided treatment plans can improve overall survival, quality of life and functional status (FS). In GA-related research in geriatric oncology, studies mainly focused on geriatric screening and GA but not on geriatric recommendations, interventions and follow-up. The aim of this study was to investigate the adherence to geriatric recommendations and subsequent actions undertaken in older patients with cancer. Patient and methods: A prospective Belgian multicenter (N=22) cohort study included patients ≥70 years with a malignant tumor upon oncologic treatment decision...
June 14, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Agnieszka Rusińska, Paweł Płudowski, Mieczysław Walczak, Maria K Borszewska-Kornacka, Artur Bossowski, Danuta Chlebna-Sokół, Justyna Czech-Kowalska, Anna Dobrzańska, Edward Franek, Ewa Helwich, Teresa Jackowska, Maria A Kalina, Jerzy Konstantynowicz, Janusz Książyk, Andrzej Lewiński, Jacek Łukaszkiewicz, Ewa Marcinowska-Suchowierska, Artur Mazur, Izabela Michałus, Jarosław Peregud-Pogorzelski, Hanna Romanowska, Marek Ruchała, Piotr Socha, Mieczysław Szalecki, Mirosław Wielgoś, Danuta Zwolińska, Arkadiusz Zygmunt
Introduction: Vitamin D deficiency is an important public health problem worldwide. Vitamin D deficiency confers a significant risk for both skeletal and non-skeletal disorders and a number of lifelong negative health outcomes. The objectives of this evidence-based guidelines document are to provide health care professionals in Poland, an updated recommendation for the prevention, diagnosis and treatment of vitamin D deficiency. Methods: A systematic literature search examining the prevention and treatment strategies for vitamin D deficiency was conducted...
2018: Frontiers in Endocrinology
Regina Elisabeth Roller-Wirnsberger, Nele van den Noortgate, Sylvie Bonin-Guillaume, Karen Andersen-Ranberg, Anette Hylen Ranhoff, Thomas Münzer, Tomasz Grodzicki, Simon Conroy, Francesco Landi, Louis Mieiro, Ulrike Dapp, Robertus van Deelen, Rannveig Sakshaug Eldholm, Nicolas Martinez-Velilla, Katrin Singler
Background: The European Academy for Medicine of Ageing (EAMA) was founded in 1995 as an "Advanced Postgraduate Course in Geriatric Medicine", in order to train future key opinion leaders in geriatric medicine. Recent changes across European Healthcare systems have changed the needs for leadership competences for geriatricians. Therefore, it became mandatory to further develop EAMA's learning objectives catalogue. Materials and methods: Following a comprehensive needs assessment among students and visiting professors of the EAMA, a template containing seven key domains derived from the needs assessment was developed...
2018: European Geriatric Medicine
Massimiliano Panella, Deborah Seys, Walter Sermeus, Luk Bruyneel, Cathy Lodewijckx, Svin Deneckere, An Sermon, Stefaan Nijs, Paulo Boto, Kris Vanhaecht
BACKGROUND: Adherence to guidelines for patients with proximal femur fracture is suboptimal. OBJECTIVE: To evaluate the effect of a care pathway for the in-hospital management of older geriatric hip fracture patients on adherence to guidelines and patient outcomes. DESIGN: The European Quality of Care Pathways study is a cluster randomized controlled trial. SETTING: 26 hospitals in Belgium, Italy and Portugal. SUBJECTS: Older adults with a proximal femur fracture (n = 514 patients) were included...
June 4, 2018: Injury
Panayiotis D Ziakas, Irene S Kourbeti, Loukia S Poulou, Georgios S Vlachogeorgos, Eleftherios Mylonakis
INTRODUCTION: Direct oral anticoagulants (DOAC) have gained an increased share over warfarin for prevention and treatment of thromboembolic disease. We studied DOAC adoption across providers and medical specialties. METHODS: Retrospective, cross-sectional analysis of Medicare Part D public use files (PUF), 2013 to 2015. We summarized prescription data for claims and drug payment, stratified by drug class, specialty and calendar year. We treated DOAC claims as a count outcome and explored patterns of expansion across prescribers via a truncated negative binomial regression...
2018: PloS One
Sharon A Levine, Serena H Chao, Lisa B Caruso, Angela H Jackson, Matthew L Russell, Megan E Young, Belle Brett
PURPOSE: Nongeriatricians must acquire skills and knowledge in geriatric medicine to ensure coordinated care of older adults' complex conditions by interspecialty and interprofessional teams. Chief residents (CRs) are an ideal target for an educational intervention. This study examined whether the Boston Medical Center (BMC) Chief Resident Immersion Training (CRIT) in the Care of Older Adults was replicable at diverse medical institutions. METHOD: Between 2008 and 2010, 12 institutions in 11 states received funding, technical support, and a common program model...
June 5, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Rafael Bielza, Asunción Mora, Francisco Zambrana, Jorge Sanjurjo, David Sanz-Rosa, Israel J Thuissard, Estefanía Arias, Marta Neira, Jorge Francisco Gómez Cerezo
BACKGROUND: Patient blood management (PBM) performs multidisciplinary strategies to optimize red blood cell (RBC) transfusion. Orthogeriatric share care models (surgeon and geriatrician manage the patient together from admission) have the goal of improving outcomes in hip fracture patients. MATERIAL AND METHODS: A prospective observational study was conducted. Patients aged ≥70 years undergoing hip fracture (HF) surgery were consecutively included. When admitted on the orthogeriatric service a PBM protocol was applied based on: perioperative antithrombotic management, intravenous iron sucrose administration and restrictive transfusion criteria...
May 30, 2018: Transfusion and Apheresis Science
Rubina Malik, Erica F Weiss, Reena Gottesman, Jessica Zwerling, Joe Verghese
OBJECTIVES: To describe the psychometric properties of the Picture-based Memory Impairment Screen (PMIS) in a multidisciplinary memory disorder center serving an ethnically and educationally diverse community. DESIGN: Cross-sectional cohort study. SETTING: Montefiore Center for Aging Brain (CAB) PARTICIPANTS: Individuals with cognitive complaints (N=405; average age 76±10, 66% female). MEASUREMENTS: A geriatrician or neurologist administered the PMIS, and a neuropsychologist administered the Blessed Information, Memory, and Concentration (BIMC) test and determined whether participants had dementia, mild cognitive impairment (MCI), or subjective cognitive complaints (SCC)...
May 29, 2018: Journal of the American Geriatrics Society
Werner Hofmann
The incidence of spondylodiscitis is increasing and attributable to an aging population with multimorbidities. Spondylodiscitis represents a life-threatening disease. Typical clinical manifestations often involve nonspecific symptoms with back pain; however, due to the frequent absence of fever the disease is often overlooked. Pathogen detection and spinal imaging with magnetic resonance imaging (MRI) are essential for the diagnosis. Identification of the causative pathogen is particularly important for initiating targeted antibiotic treatment...
June 2018: Der Nervenarzt
Jenny Neuburger, Colin Currie, Robert Wakeman, Theo Georghiou, Chris Boulton, Antony Johansen, Carmen Tsang, Helen Wilson, David A Cromwell, Jan van der Meulen
Objective: to describe differences in care and 30-day mortality of patients admitted with hip fracture on weekends (Saturday-Sunday) compared to weekdays (Monday-Friday), and their relationship to the organisation of care. Methods: data came from the National Hip Fracture Database (NHFD) linked to ONS mortality data on 52,599 patients presenting to 162 units in England between 1 January and 31 December 2014. This was combined with information on geriatrician staffing and major trauma centre (MTC) status...
May 22, 2018: Age and Ageing
Aldis H Petriceks, John C Olivas, Sakti Srivastava
It is no secret that the average age of the U.S. population is increasing, and this has special significance for the U.S. health care system. The number of individuals above 65 years old is predicted to increase 55% by 2030, and all the while, there is a looming physician shortage, one especially relevant for Geriatricians. Therefore, current Geriatricians must have objective information to assess the past, present, and future state of this important specialty. However, little literature exists regarding the recent changes in Geriatrics-related graduate medical education programs...
January 2018: Gerontology & Geriatric Medicine
Katrina A Booth, Emily E Simmons, Andres F Viles, Whitney A Gray, Kelsey R Kennedy, Shari H Biswal, Jason A Lowe, Anisa Xhaja, Richard E Kennedy, Cynthia J Brown, Kellie L Flood
The Acute Care for Elders (ACE) Unit model improves cognitive and functional outcomes for hospitalized elders but reaches a small proportion of patients. To disseminate ACE Unit principles, we piloted the "Virtual ACE Intervention" that standardizes care processes for cognition and function without daily geriatrician oversight on two non-ACE units. The Virtual ACE Intervention includes staff training on geriatric assessments for cognition and function and on nurse-driven care algorithms. Completion of the geriatric assessments by nursing staff in patients aged 65 years and older and measures of patient mobility and prevalence of an abnormal delirium screening score were compared preintervention and postintervention...
May 23, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Alexandra Ai Abel
The 20th Annual Autumn Meeting of the British Society for Heart Failure took place on the 23-24 November 2017 at the Queen Elizabeth II Conference Centre, London, UK. Over 800 delegates were in attendance: a multidisciplinary league of professionals who treat patients with heart failure, including specialist nurses, trainees, cardiologists, geriatricians, pharmacists and general practitioners. The theme of the conference was 'three decades of heart failure' and celebrated the success of modern heart failure management...
May 1, 2018: Future Cardiology
Jihui Lyu, Wenjie Li, Xiangjiang Rong, Lian Wei, Nayan Huang, Mei Champ, Qian Xiong, Xueli Chen, Mo Li, Fangling Li
INTRODUCTION: Many studies suggest that Tai Chi exercise is a safe and appropriate mind-body exercise for older people and effectively slows down age-related cognitive decline. A set of bespoke Tai Chi exercise named 'Cognition Protecting Tai Chi' (CPT) has been created for older people with cognitive impairments by the research team of geriatricians, neurologists, rehabilitation specialists, experts of sports medicine and experienced practitioners of traditional Chinese medicine. This trial is designed to evaluate its effects on cognitive function, behaviour/moods, risk of falls and activities of daily living of the participants with mild dementia...
May 14, 2018: BMJ Open
Tak Man Wong, Frankie K L Leung, Tak Wing Lau, Christian Fang, Felix H W Chan, Jun Wu
Introduction: The incidence of hip fracture is projected to increase in the next 25 years as the world population ages. Hip fracture is often associated with subsequent readmission and mortality. Nevertheless, elderly patients often may not achieve the same level of functional ability as prior to their injury. Several studies have shown that close collaboration between orthopedic surgeons and geriatricians can improve such outcomes and Geriatric Day Hospital (GDH) is one of the examples of collaboration to improve such outcomes...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Kevin Pottie, Wade Thompson, Simon Davies, Jean Grenier, Cheryl A Sadowski, Vivian Welch, Anne Holbrook, Cynthia Boyd, Robert Swenson, Andy Ma, Barbara Farrell
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop benzodiazepine receptor agonists (BZRAs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes. METHODS: The overall team comprised 8 clinicians (1 family physician, 2 psychiatrists, 1 clinical psychologist, 1 clinical pharmacologist, 2 clinical pharmacists, and 1 geriatrician) and a methodologist; members disclosed conflicts of interest...
May 2018: Canadian Family Physician Médecin de Famille Canadien
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