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https://www.readbyqxmd.com/read/27927732/trauma-informed-hospice-and-palliative-care
#1
Barbara L Ganzel
This review highlights the need to integrate trauma-informed practices into hospice and palliative care. The pervasiveness of psychological trauma exposure has been established in the general population and among the elderly adults. Moreover, there is emerging evidence for multiple additional opportunities for exposure to psychological trauma at or near the end of life. For example, many people experience intensive medical interventions prior to their admission to hospice and/or palliative care, and there is increasing recognition that these interventions may be traumatic...
December 7, 2016: Gerontologist
https://www.readbyqxmd.com/read/27911302/association-between-cognitive-status-before-surgery-and-outcomes-in-elderly-patients-with-hip-fracture-in-a-dedicated-orthogeriatric-care-pathway
#2
Lorene Zerah, Judith Cohen-Bittan, Mathieu Raux, Anthony Meziere, Cendrine Tourette, Christian Neri, Marc Verny, Bruno Riou, Frederic Khiami, Jacques Boddaert
BACKGROUND: Dementia is associated with a worse prognosis of hip fracture, but the impact of a dedicated geriatric care pathway on the prognosis of these patients has not been evaluated. OBJECTIVE: According to the cognitive status before surgery, our main objective was to compare mortality rate at 6 months; secondary outcomes were to compare in-hospital complications, the risk of new institutionalization, and the ability to walk at 6 months. METHODS: Between 2009 and 2015, all patients (>70 years) admitted after hip fracture surgery into a dedicated unit of peri-operative geriatric care were included: patients with dementia (DP), without dementia (NDP), and with cognitive status not determined (CSND)...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27900414/-comment-on-dexmedetomidine-for-delirium-prophylaxis-in-elderly-patients-after-non-cardiac-surgery-in-the-intensive-care-unit
#3
J Van Waesberghe, A Eisert, M Coburn
No abstract text is available yet for this article.
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27890870/improving-the-quality-of-postgraduate-education-in-traditional-japanese-kampo-medicine-for-junior-residents-an-exploratory-survey-conducted-in-five-institutions-in-the-tohoku-area
#4
Shin Takayama, Seiichi Kobayashi, Soichiro Kaneko, Masao Tabata, Shinya Sato, Keiichi Ishikawa, Saya Suzuki, Ryutaro Arita, Natsumi Saito, Tetsuharu Kamiya, Hitoshi Nishikawa, Yuka Ikeno, Junichi Tanaka, Minoru Ohsawa, Akiko Kikuchi, Takehiro Numata, Hitoshi Kuroda, Michiaki Abe, Satoru Ishibashi, Nobuo Yaegashi, Tadashi Ishii
Traditional Japanese (Kampo) medicine has been widely applied in general medicine in Japan. In 2001, the model core curriculum for Japanese medical education was revised to include Kampo medicine. Since 2007, all 80 Japanese medical schools have incorporated it within their programs. However, postgraduate training or instruction of Kampo medicine has not been recognized as a goal for the clinical training of junior residents by Japan's Ministry of Health, Labour and Welfare; little is known about postgraduate Kampo medicine education...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27874185/translating-delirium-prevention-strategies-for-elderly-adults-with-hip-fracture-into-routine-clinical-care-a-pragmatic-clinical-trial
#5
Susan Freter, Katalin Koller, Michael Dunbar, Chris MacKnight, Kenneth Rockwood
OBJECTIVES: To compare the feasibility (adherence) and effectiveness (prevalence of delirium, length of stay, mortality, discharge site) of delirium-friendly preprinted postoperative orders (PPOs) for individuals with hip fracture, administered by regular orthopedic nurses, with routine postoperative orders. DESIGN: Pragmatic clinical trial to evaluate a quality improvement intervention. SETTING: Tertiary care hospital. PARTICIPANTS: Individuals aged 65 and older admitted for hip fracture repair (N = 283)...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27872590/test-retest-reliability-of-a-serious-game-for-delirium-screening-in-the-emergency-department
#6
Tiffany Tong, Mark Chignell, Mary C Tierney, Jacques S Lee
Introduction: Cognitive screening in settings such as emergency departments (ED) is frequently carried out using paper-and-pencil tests that require administration by trained staff. These assessments often compete with other clinical duties and thus may not be routinely administered in these busy settings. Literature has shown that the presence of cognitive impairments such as dementia and delirium are often missed in older ED patients. Failure to recognize delirium can have devastating consequences including increased mortality (Kakuma et al...
2016: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/27847677/the-use-of-moca-and-other-cognitive-tests-in-evaluation-of-cognitive-impairment-in-elderly-patients-undergoing-arthroplasty
#7
Jukka Puustinen, Liisa Luostarinen, Markku Luostarinen, Veijo Pulliainen, Heini Huhtala, Marjo Soini, Jaana Suhonen
OBJECTIVE: To examine the prevalence and effect of cognitive impairment on treatment outcomes in elderly patients undergoing arthroplasty and to describe the feasibility of cognitive tests. MATERIALS AND METHODS: The participants were 52 patients with a mean age of 78 years 11 months (SD: 3.3), waiting for primary arthroplasty. We translated Montreal Cognitive Assessment (MoCA) into Finnish and compared it with Mini-Mental State Examination (MMSE), Mini-Cog, and clock-drawing tests prior to and 3 months after the surgery...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27845806/hospitalized-older-adults-with-established-delirium-recognition-documentation-and-reporting
#8
Margarete L Zalon, Sonia Sandhaus, Mary Kovaleski, Paula Roe-Prior
Delirium, a life-threatening complication for hospitalized older adults associated with adverse outcomes, is often underrecognized and underreported. The purpose of the current study was to analyze delirium documentation for hospitalized older adults. Charts of 34 patients, aged 71 and older with documented delirium and referral to a Hospital Elder Life Program, were reviewed. With the exception of International Classification of Diseases-9 coding, delirium was only mentioned in 12 (35.3%) charts, although descriptors potentially indicative of delirium were usually recorded...
November 15, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27833221/profile-of-patients-attending-psychogeriatric-clinic-in-a-tertiary-care-setting
#9
Suresh Neethu, P V Indu, Prabhakaran Anil
BACKGROUND: Proportion of elderly is increasing among the total population of Kerala, and mental health problems of this group are unique. OBJECTIVES: To assess the clinical and sociodemographic profile of patients attending Psychogeriatric Clinic in a tertiary care center and to study the correlation of sociodemographic and clinical variables with psychiatric diagnoses in this population. MATERIALS AND METHODS: A retrospective chart review of patients, who attended the Psychogeriatric Clinic of a tertiary care center over a period of 1 year, was done...
September 2016: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/27830365/haloperidol-prophylaxis-for-preventing-aggravation-of-postoperative-delirium-in-elderly-patients-a-randomized-open-label-prospective-trial
#10
Shinji Fukata, Yasuji Kawabata, Ken Fujishiro, Yuichi Kitagawa, Kojiro Kuroiwa, Hirotoshi Akiyama, Marie Takemura, Masahiko Ando, Hideyuki Hattori
PURPOSES: The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients. METHODS: A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were divided into two groups: the intervention group (n = 101) received prophylactic haloperidol (5 mg); the control group (n = 100) did not. Haloperidol was administered daily during postoperative days 0-5 to the patients who presented with NEECHAM scores of 20-24 when measured at 18:00...
November 9, 2016: Surgery Today
https://www.readbyqxmd.com/read/27822212/systemic-hmgb1-neutralization-prevents-postoperative-neurocognitive-dysfunction-in-aged-rats
#11
Niccolò Terrando, Ting Yang, Xueqin Wang, Jiakai Fang, Mengya Cao, Ulf Andersson, Harris Helena Erlandsson, Wen Ouyang, Jianbin Tong
Postoperative neurocognitive disorders are common complications in elderly patients following surgery or critical illness. High mobility group box 1 protein (HMGB1) is rapidly released after tissue trauma and critically involved in response to sterile injury. Herein, we assessed the role of HMGB1 after liver surgery in aged rats and explored the therapeutic potential of a neutralizing anti-HMGB1 monoclonal antibody in a clinically relevant model of postoperative neurocognitive disorders. Nineteen to twenty-two months Sprague-Dawley rats were randomly assigned as: (1) control with saline; (2) surgery, a partial hepatolobectomy under sevoflurane anesthesia and analgesia, + immunoglobulin G as control antibody; (3) surgery + anti-HMGB1...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27822051/production-of-inflammatory-cytokines-cortisol-and-a%C3%AE-1-40-in-elderly-oral-cancer-patients-with-postoperative-delirium
#12
Lulu Sun, Peiyu Jia, Junfeng Zhang, Xin Zhang, Yiwei Zhang, Hong Jiang, Wei Jiang, Yong Guo
AIM: Pathophysiological disorders after surgery might be related to postoperative delirium (POD). This study was designed to elucidate the pathogenesis of POD in elderly oral cancer patients by determining the perioperative kinetics of inflammatory cytokines, cortisol, and amyloid β1-40 (Aβ1-40). METHODS: A total of 257 elderly oral cancer patients who underwent tumor resection surgery were selected. Venous blood was collected prior to surgery (T0), at the end of surgery (T1), and at 12 hours after surgery (T2)...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27809817/a-personality-trait-contributes-to-the-occurrence-of-postoperative-delirium-a-prospective-study
#13
Jung Eun Shin, Sunghyon Kyeong, Jong-Seok Lee, Jin Young Park, Woo Suk Lee, Jae-Jin Kim, Kyu Hyun Yang
BACKGROUND: Although various physical risk factors for delirium have been identified, the effect of psychological aspects is currently unknown. This study aimed to examine psychological risk factors for postoperative delirium and to identify hidden subgroups of delirium in clinical and psychological feature space. METHODS: Among 200 patients with hip fracture, 78 elderly patients were prospectively evaluated for clinical and psychological assessments before surgery...
November 3, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27809575/a-systematic-review-of-postoperative-cognitive-decline-following-open-and-endovascular-aortic-aneurysm-surgery
#14
R A Benson, B A Ozdemir, D Matthews, I M Loftus
OBJECTIVES Postoperative cognitive decline (POCD) is a well-recognised neurological phenomenon following major surgery. Most commonly seen in elderly patients, it has direct links to increased long-term morbidity and reduced quality of life. Its incidence following open and endovascular abdominal and thoracic aneurysm surgery is unclear. The purpose of this systematic review is to collate available evidence for POCD following abdominal and thoracic aortic surgery, and to identify continuing controversies directing future research...
November 4, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27791037/orthopedic-surgery-modulates-neuropeptides-and-bdnf-expression-at-the-spinal-and-hippocampal-levels
#15
Ming-Dong Zhang, Swapnali Barde, Ting Yang, Beilei Lei, Lars I Eriksson, Joseph P Mathew, Thomas Andreska, Katerina Akassoglou, Tibor Harkany, Tomas G M Hökfelt, Niccolò Terrando
Pain is a critical component hindering recovery and regaining of function after surgery, particularly in the elderly. Understanding the role of pain signaling after surgery may lead to novel interventions for common complications such as delirium and postoperative cognitive dysfunction. Using a model of tibial fracture with intramedullary pinning in male mice, associated with cognitive deficits, we characterized the effects on the primary somatosensory system. Here we show that tibial fracture with pinning triggers cold allodynia and up-regulates nerve injury and inflammatory markers in dorsal root ganglia (DRGs) and spinal cord up to 2 wk after intervention...
October 25, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27789263/postoperative-cerebral-dysfunction-in-the-elderly-diagnosis-and-prophylaxis
#16
D Benhamou, A Brouquet
Post-operative cerebral dysfunction includes delirium, usually occurring early and reversible, and post-operative cognitive disorders, usually occurring later and prolonged. This is a frequent complication in patients older than 75 years old. The two neurological pictures are often inter-related. The pathophysiology of both entities is similar and related to post-operative neuro-inflammation; therefore onset may occur independently of any surgical complication. Post-operative cerebral dysfunction is a serious organic complication...
October 24, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27772564/attention-vigilance-and-visuospatial-function-in-hospitalized-elderly-medical-patients-relationship-to-neurocognitive-diagnosis
#17
Maeve Leonard, Henry O'Connell, Olugbenga Williams, Fahad Awan, Chris Exton, Margaret O'Connor, Dimitrios Adamis, Colum Dunne, Walter Cullen, David J Meagher
OBJECTIVE: Efficient detection of neurocognitive disorders is a key diagnostic challenge. We explored how simple bedside tests of attention, vigilance and visuospatial function might assist in identifying delirium in hospitalized patients. METHODS: Performance on a battery of bedside cognitive tests was compared in elderly medical inpatients with DSM-IV delirium, dementia, comorbid delirium-dementia, and no neurocognitive disorder. RESULTS: 193 patients [mean age 79...
November 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27766672/validating-the-4a-s-test-in-screening-for-delirium-in-a-culturally-diverse-geriatric-inpatient-population
#18
Jayita De, Anne P F Wand, Peter I Smerdely, Glenn E Hunt
OBJECTIVE: To measure the diagnostic accuracy of the 4A's test in screening for delirium in geriatric inpatients from culturally diverse backgrounds. METHODS: A prospective study was conducted with patients admitted to the geriatric and orthogeriatric services of a tertiary teaching hospital. Consenting participants aged 65 years and over were screened for delirium with the 4AT by nursing staff within 72 h of admission. The diagnosis of delirium was made separately by expert assessors, responsible for the participant's clinical care, blinded to the 4AT score, within 30 min of the 4AT assessment using the DSM 5 criteria and the Confusion Assessment Method...
October 20, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27765479/etiologies-and-delirium-rates-of-elderly-ed-patients-with-acutely-altered-mental-status-a-multicenter-prospective-study
#19
Mehmet Ali Aslaner, Mustafa Boz, Ali Çelik, Asliddin Ahmedali, Sercan Eroğlu, Nalan Metin Aksu, Serkan Emre Eroğlu
OBJECTIVES: Altered mental status (AMS) is a challenging diagnosis in older patients and has a large range of etiologies. The aim of this study was to investigate the nature of such etiologies for physicians to be better aware of AMS backgrounds and hence improve outcomes and mortality rates. METHODS: This prospective observational study was conducted at 4 emergency departments. Patients 65 years and older who presented to the emergency department with acute AMS (≤1 week), with symptoms ranging from comas and combativeness, were eligible for inclusion in this study...
October 5, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27747805/haloperidol-use-among-elderly-patients-undergoing-surgery-a-retrospective-1-year-study-in-a-hospital-population
#20
Harmke Nijboer, Geert Lefeber, Alidair McLullich, Barbara van Munster
BACKGROUND: Haloperidol, frequently used for delirium, can lead to serious side effects, of which QTc prolongation is the most worrisome since it is associated with an increased risk of fatal cardiac arrhythmia. OBJECTIVES: The aim of this study was to measure the frequency of haloperidol use after procedures in patients aged ≥65 years in a hospital in the Netherlands. METHODS: This was a retrospective study among patients hospitalized in the Netherlands who were aged ≥65 years and who underwent a procedure between January 2008 and January 2009...
March 2016: Drugs—Real World Outcomes
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