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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/27925292/cognitive-impairment-in-parkinson-s-disease-impact-on-quality-of-life-of-carers
#1
R A Lawson, A J Yarnall, F Johnston, G W Duncan, T K Khoo, D Collerton, J P Taylor, D J Burn
BACKGROUND: The quality of life (QoL) of informal caregivers of people with Parkinson's disease (PD) (PwP) can be affected by the caring role. Because of cognitive symptoms and diminished activities of daily living, in addition to the management of motor symptoms, carers of PwP and cognitive impairment may experience increased levels of burden and poorer QoL compared with carers of PwP without cognitive impairment. This study aimed to investigate the impact of cognitive impairment in PD upon QoL of carers...
December 7, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27914295/sarcopenia-and-post-hospital-outcomes-in-older-adults-a-longitudinal-study
#2
Mario Ulises Pérez-Zepeda, Aldo Sgaravatti, Elsa Dent
INTRODUCTION: Sarcopenia poses a significant problem for older adults, yet very little is known about this medical condition in the hospital setting. The aims of this hospital-based study were to determine: (i) the prevalence of sarcopenia; (ii) factors associated with sarcopenia; and (iii) the association of sarcopenia with adverse clinical outcomes post-hospitalisation. METHODS: This is a longitudinal analysis of consecutive patients aged ≥70 years admitted to a Geriatric Management and Evaluation Unit (GEMU) ward...
November 17, 2016: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27908282/role-of-geriatric-intervention-in-the-treatment-of-older-patients-with-cancer-rationale-and-design-of-a-phase-iii-multicenter-trial
#3
Pierre Soubeyran, Catherine Terret, Carine Bellera, Franck Bonnetain, Olivier Saint Jean, Angéline Galvin, Camille Chakiba, Marie-Dominique Zwolakowski, Simone Mathoulin-Pélissier, Muriel Rainfray
BACKGROUND: In the general geriatric population, programs linking geriatric evaluation with interventions are effective for improving functional status and survival of the patients. Whether or not these interventions improve health related quality of life (HRQoL) or overall survival (OS) in older patients with cancer is not yet clear. Indeed, randomized data on the effect of such interventions on survival and HRQoL are rare and conflicting. We describe the rationale and design of a phase III multicenter trial aimed at assessing the efficacy of geriatric intervention in the management of elderly patients with cancer...
December 1, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27901275/peripheral-nerve-blocks-for-the-treatment-of-headache-in-older-adults-a-retrospective-study
#4
Jacob R Hascalovici, Matthew S Robbins
OBJECTIVE: The objective of this study is to provide demographical and clinical descriptions of patients age 65 years old and older who were treated with peripheral nerve blocks (PNBs) at our institution and evaluate the safety and efficacy of this treatment. BACKGROUND: Headache disorders are common, disabling chronic neurological diseases that often persist with advancing age. Geriatric headache management poses unique therapeutic challenges because of considerations of comorbidity, drug interactions, and adverse effects...
November 30, 2016: Headache
https://www.readbyqxmd.com/read/27895425/folfirinox-in-elderly-patients-with-pancreatic-or-colorectal-cancer-tolerance-and-efficacy
#5
Jean-Florian Guion-Dusserre, Aurélie Bertaut, François Ghiringhelli, Julie Vincent, Valérie Quipourt, Sophie Marilier, Zoé Tharin, Leila Bengrine-Lefevre
AIM: To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS: This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m(2) intraveinous infusion over 46 h) repeated every 2 wk...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27864240/new-horizons-in-orthostatic-hypotension
#6
REVIEW
James Frith, Steve W Parry
BACKGROUND: orthostatic hypotension (OH) is a common disabling condition associated with increased morbidity and mortality. Much of the evidence available is derived from younger populations with chronic neurological disease leading to uncertainty for the diagnosis and management of older people. OBJECTIVE: to provide an overview of recent and emerging evidence for the diagnosis, management and prognosis of OH in older persons. METHODS: a narrative review of recent studies, emerging therapies and relevant regulatory updates...
November 17, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27842907/are-enhanced-recovery-programs-in-colorectal-surgery-feasible-and-useful-in-the-elderly-a-systematic-review-of-the-literature
#7
M-V Launay-Savary, M Mathonnet, A Theissen, S Ostermann, A Raynaud-Simon, K Slim
INTRODUCTION: Enhanced recovery programs (ERP) are no longer questionable in the management of patients undergoing surgery. However, there is some doubt as to their feasibility and efficacy in the elderly. Our goal was to systematically review the evidence-based literature concerning the feasibility of ERP in elderly patients undergoing colorectal surgery. MATERIAL AND METHODS: The PubMed and Cochrane Database for systematic reviews as well as the "grey" literature between 2000 and 2015 were sought...
November 11, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27831798/an-official-american-thoracic-society-workshop-report-evaluation-and-management-of-asthma-in-the-elderly
#8
Gwen S Skloot, Paula J Busse, Sidney S Braman, Elizabeth J Kovacs, Anne E Dixon, Carlos A Vaz Fragoso, Nicola Scichilone, Y S Prakash, Christina M Pabelick, Sameer K Mathur, Nicola A Hanania, Wendy C Moore, Peter G Gibson, Susan Zieman, Betina B Ragless
Asthma in the elderly (>65 yr old) is common and associated with higher morbidity and mortality than asthma in younger patients. The poor outcomes in this group are due, in part, to underdiagnosis and undertreatment. There are a variety of factors related to aging itself that affect the presentation of asthma in the elderly and influence diagnosis and management. Structural changes in the aging lung superimposed on structural changes due to asthma itself can worsen the disease and physiologic function. Changes in the aging immune system influence the cellular composition and function in asthmatic airways...
November 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27803007/management-of-chronic-lymphocytic-leukemia-cll-in-the-elderly-a-position-paper-from-an-international-society-of-geriatric-oncology-siog-task-force
#9
REVIEW
R Stauder, B Eichhorst, M Hamaker, K Kaplanov, V Morrison, A Österborg, I Poddubnaya, J A Woyach, T Shanafelt, L Smolej, L Ysebaert, V Goede
Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is above seventy years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living, and social support...
November 1, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/27785733/the-efficacy-and-safety-of-the-fentanyl-iontophoretic-transdermal-system-ionsys-%C3%A2-in-the-geriatric-population-results-of-a-meta-analysis-of-phase%C3%A2-iii-and-iiib-trials
#10
Eugene R Viscusi, Li Ding, Loretta M Itri
BACKGROUND AND OBJECTIVES: Acute postoperative pain management in the geriatric patient can be challenging, including their response to medications. The purpose of this analysis was to evaluate whether the efficacy and safety profile of fentanyl iontophoretic transdermal system (ITS) (IONSYS(®)) was similar in geriatric (≥65 years) and non-geriatric (<65 years) patients. METHODS: Efficacy and safety data from three randomized, double-blind, placebo-controlled trials and four randomized, open-label, active-comparator trials were utilized for this analysis...
October 27, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27785425/how-to-optimally-manage-elderly-bladder-cancer-patients
#11
REVIEW
Francesco Soria, Marco Moschini, Stephan Korn, Shahrokh F Shariat
Bladder cancer (BCa) is a disease of the elderly and as the population is aging, BCa will become an even bigger public health challenge in the future. Nowadays the correct management of BCa in the elderly remains controversial. The purpose of this article was to review the previous literature to summarize the current knowledge. Using Medline, a non-systematic review was performed including articles between January 2000 and February 2016 in order to describe the management of BCa in the elderly in all its aspects...
October 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/27785002/european-society-for-swallowing-disorders-european-union-geriatric-medicine-society-white-paper-oropharyngeal-dysphagia-as-a-geriatric-syndrome
#12
REVIEW
Laura Wj Baijens, Pere Clavé, Patrick Cras, Olle Ekberg, Alexandre Forster, Gerald F Kolb, Jean-Claude Leners, Stefano Masiero, Jesús Mateos-Nozal, Omar Ortega, David G Smithard, Renée Speyer, Margaret Walshe
This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization's classification of diseases...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27774584/montefiore-einstein-center-for-the-aging-brain-preliminary-data
#13
Joe Verghese, Rubina Malik, Jessica Zwerling
Given the multifaceted nature of dementia care management, an interdisciplinary comprehensive clinical approach is necessary. We describe our one-year experience with outpatient based dementia care at the Montefiore-Einstein Center for the Aging Brain (CAB) involving an multispecialty team of geriatricians, neurologists, and neuropsychologists, supported by geriatric psychiatrists, physiatrists, and social services. The goals of the CAB is to maximize dementia outcomes, including regular monitoring of patient's health and cognition, education and support to patients, their families and caregivers; initiation of pharmacological and non-pharmacological treatments as appropriate, and the facilitation of access to clinical trials...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27760535/the-haiti-medical-education-project-development-and-analysis-of-a-competency-based-continuing-medical-education-course-in-haiti-through-distance-learning
#14
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27749162/development-and-preliminary-evaluation-of-the-resident-coordinated-transitional-care-rc-trac-program-a-sustainable-option-for-transitional-care-education
#15
E Chapman, A Eastman, A Gilmore-Bykovskyi, B Vogelman, A J Kind
Older adults often face poor outcomes when transitioning from hospital to home. Although physicians play a key role in overseeing transitions, there is a lack of practice-based educational programs that prepare resident physicians to manage care transitions of older adults. An educational intervention to provide residents with real-life transitional care practice was therefore developed-Resident-coordinated Transitional Care (RC-TraC). RC-TraC adapted the evidence-based Coordinated-Transitional Care (C-TraC) nurse role for residents, providing opportunities to follow patients during the peri-hospital period without additional costs to the residency program...
October 17, 2016: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/27743841/health-social-and-economic-variables-associated-with-depression-among-older-people-in-low-and-middle-income-countries-world-health-organization-study-on-global-ageing-and-adult-health
#16
Ethel M Brinda, Anto P Rajkumar, Jǿrn Attermann, Ulf G Gerdtham, Ulrika Enemark, Kuruthukulangara S Jacob
OBJECTIVE: Although depression among older people is an important public health problem worldwide, systematic studies evaluating its prevalence and determinants in low and middle income countries (LMICs) are sparse. The biopsychosocial model of depression and prevailing socioeconomic hardships for older people in LMICs have provided the impetus to determine the prevalence of geriatric depression; to study its associations with health, social, and economic variables; and to investigate socioeconomic inequalities in depression prevalence in LMICs...
December 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27742527/risk-factors-for-adverse-drug-reactions-in-older-subjects-hospitalized-in-a-dedicated-dementia-unit
#17
Lukshe Kanagaratnam, Moustapha Dramé, Jean-Luc Novella, Thierry Trenque, Clarisse Joachim, Pierre Nazeyrollas, Damien Jolly, Rachid Mahmoudi
OBJECTIVE: To identify risk factors for the occurrence of adverse drug reactions (ADRs) based on geriatric evaluation. DESIGN: Longitudinal prospective study from May 2010 to November 2011. SETTING: Dedicated acute geriatric care unit specializing in the management of patients with dementia syndrome (Alzheimer disease or related syndromes) at the University Hospital of Reims, France. PARTICIPANTS: Older patients with dementia syndrome (Alzheimer disease or related syndromes)...
September 1, 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27733902/perception-of-primary-care-physicians-on-the-impact-of-comprehensive-geriatric-assessment-what-is-the-next-step
#18
Pei Chen, Michael A Steinman
Older adults are at high risk of developing multimorbidity, and the high levels of clinical and psychosocial complexity in this population pose special challenges for primary care physicians (PCPs). As a way to improve the care for the older adults, a number of health systems have developed programs to provide comprehensive geriatric assessment (CGA), which generally refers to an intensive interprofessional evaluation and management of geriatric syndromes with the goals of maximizing health in aging. Sternberg and Bentur examined the impact of CGA as perceived by PCPs, the PCPs attitude toward CGA, and their satisfaction with CGA...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27723124/how-do-we-enhance-undergraduate-healthcare-education-in-dementia-a-review-of-the-role-of-innovative-approaches-and-development-of-the-time-for-dementia-programme
#19
REVIEW
Sube Banerjee, Nicolas Farina, Stephanie Daley, Wendy Grosvenor, Leila Hughes, Molly Hebditch, Sophie Mackrell, Ramin Nilforooshan, Chris Wyatt, Kay de Vries, Inam Haq, Juliet Wright
OBJECTIVES: Traditional healthcare education, delivered through a series of time-limited clinical placements, often fails to deliver an understanding of the experiences of those with long-term conditions, a growing issue for healthcare systems. Responses include longitudinal integrated clerkships and senior mentor programmes allowing students' longer placements, continuity of contact and opportunities to learn about chronic illness and patient experience. We review their development and delivery in dementia and present the Time for Dementia (TFD) Programme, a novel 2-year interdisciplinary educational programme...
October 10, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27714762/reductions-in-medication-related-hospitalizations-in-older-adults-with-medication-management-by-hospital-and-community-pharmacists-a-quasi-experimental-study
#20
Karen L Pellegrin, Les Krenk, Sheena Jolson Oakes, Anita Ciarleglio, Joanne Lynn, Terry McInnis, Alistair W Bairos, Lara Gomez, Mercedes Benitez McCrary, Alexandra L Hanlon, Jill Miyamura
OBJECTIVES: To evaluate the association between a system of medication management services provided by specially trained hospital and community pharmacists (Pharm2Pharm) and rates and costs of medication-related hospitalization in older adults. DESIGN: Quasi-experimental interrupted time series design comparing intervention and nonintervention hospitals using a mixed-effects analysis that modeled the intervention as a time-dependent variable. SETTING: Sequential implementation of Pharm2Pharm at six general nonfederal acute care hospitals in Hawaii with more than 50 beds in 2013 and 2014...
October 7, 2016: Journal of the American Geriatrics Society
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