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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/28914223/educator-readiness-to-improve-gerontological-curricula-in-health-and-social-service-education
#1
Lynn McCleary, Veronique Boscart, Peter Donahue, Kelsey Harvey
This study investigated the state of gerontology content in health and social service education programs in Ontario, and readiness indicators for change among administrators and faculty. We conducted a survey of teaching faculty (n = 100) and deans or directors (n = 56) of 89 education programs, which revealed mixed evidence on readiness for change. Most respondents thought their programs were adequate but needed enhancement. However, they were unaware of published gerontological competencies with which to evaluate their curricula...
September 15, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28903581/geriatric-assessment-can-predict-outcomes-of-endoscopic-surgery-for-benign-prostatic-hyperplasia-in-elderly-patients
#2
Thomas Pichon, Cyrille Launay, Thibaut Culty, Denis Chautard, Nadine Collet, Nicolas Hoareau, Elena Brassart, Pierre Bigot, Olivier Beauchet, Abdel-Rahmene Azzouzi, Arnaud Cerruti, Souhil Lebdai
Ojectives: Surgical management of benign prostatic hyperplasia (BPH) in elderly patients is associated with higher morbidity and mortality. This arises the question of benefice and risk balance. We conducted a prospective observational study to evaluate the results of endoscopic surgery for BPH in elderly patients, according to geriatric assessment. PATIENTS AND METHODS: We included prospectively 60 patients over 75 years, with an indwelling catheter for acute or chronic retention, who were candidates to endoscopic surgery for BPH...
September 13, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28895980/coping-with-the-pain-of-elderly-pain-patients-nursing-approach
#3
Burcu Babadağ, Güler Balcı Alparslan, Sacit Güleç
OBJECTIVES: This study was designed to examine methods used by elderly patients to cope with pain and serve as a guide for nurses. METHODS: This descriptive survey was carried out with geriatric patients (n=100) aged 60 years or more in inpatient Algology Unit of a university hospital between November 28, 2014 and January 28, 2015. Data were collected using descriptive characteristics questionnaire prepared based on review of the literature and via one-on-one interviews using Pain Coping Questionnaire (PCQ)...
April 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/28890165/reduction-of-the-anticholinergic-burden-makes-it-possible-to-decrease-behavioral-and-psychological-symptoms-of-dementia
#4
Yacine Jaïdi, Vignon Nonnonhou, Lukshe Kanagaratnam, Laurie Anne Bertholon, Sarah Badr, Vivien Noël, Jean-Luc Novella, Rachid Mahmoudi
OBJECTIVE: The aim of this study was to evaluate the impact of a reduction of the anticholinergic burden (AB) on the frequency and severity of behavioral and psychological symptoms of dementia (BPSD) and their repercussions on the care team (occupational disruptiveness). METHODS: In this prospective, single-center study in an acute care unit for Alzheimer disease (AD) and related disorders, 125 elderly subjects (mean age: 84.4 years) with dementia presented with BPSD...
August 14, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28872034/interest-of-a-medical-surgical-geriatric-unit-in-a-district-hospital-a-retrospective-study
#5
Baptiste Gonnaud, Radia Spiga, Selim Hamache, Patricia Ramboa, Corinne Momplot, Magali Tardy, Régis Gonthier
BACKGROUND: Orthogeriatric units have shown through several studies their effectiveness on reducing the morbidity and mortality after hip fracture. What about other emergency surgeries at the elderly? We evaluated the results of a small medical surgical geriatric unit (UMCG) for all the not sheduled surgeries. METHODS: A retrospective sudy has been done, analyzing management of patients over 75 years after an emergency surgery, between 1(st) January 2013 and 15 February 2014 for the surgical unit, and between 15 February 2014 and 15 April 2014 for the UMCG...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28857406/trend-of-cardiovascular-risk-factors-in-the-older-iranian-population-2002-2014
#6
Ali Eslami, Mojtaba Lotfaliany, Samaneh Akbarpour, Fereidoun Azizi, Farzad Hadaegh
AIM: Current study aimed to investigate the sex-stratified secular trend of cardiovascular disease risk factors among an older population in Iran during a median follow-up period of 8.76 years. METHODS: A total of 1490 participants (733 women) aged ≥60 years were evaluated in four study phases of 2002-2005, 2005-2008, 2008-2011 and 2011-2014. The trends of cardiovascular disease risk factors for each sex were estimated using generalized estimating equations...
August 31, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28852954/pressure-ulcers-are-associated-with-6-month-mortality-in-elderly-patients-with-hip-fracture-managed-in-orthogeriatric-care-pathway
#7
Emmanuelle Magny, Helene Vallet, Judith Cohen-Bittan, Mathieu Raux, Antony Meziere, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Despite orthogeriatric management, 12% of the elderly experienced PUs after hip fracture surgery. PUs were significantly associated with a low albumin level, history of atrial fibrillation coronary artery disease, and diabetes. The risk ratio of death at 6 months associated with pressure ulcer was 2.38 (95% CI 1.31-4.32%, p = 0.044). INTRODUCTION: Pressure ulcers in hip fracture patients are frequent and associated with a poor outcome. An orthogeriatric management, recommended by international guidelines in hip fracture patients and including pressure ulcer prevention and treatment, could influence causes and consequences of pressure ulcer...
August 29, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28852239/physical-comorbidity-and-its-impact-on-symptom-profile-of-depression-among-elderly-patients-attending-psychiatry-services-of-a-tertiary-care-hospital
#8
Sandeep Grover, Eish Dalla, Aseem Mehra, Subho Chakrabarti, Ajit Avasthi
AIM: This study aimed to evaluate the prevalence of physical comorbidities among elderly patients with depression attending psychiatric services and the secondary aim of the study was to evaluate the influence of physical comorbidities on symptom profile of depression. METHODOLOGY: 140 patients with a diagnosis of depression as per the International Classification of Diseases-10 criteria were evaluated on Geriatric Depression Scale (GDS) and a physical comorbidity checklist...
July 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28851511/polypharmacy-potentially-inappropriate-medications-and-drug-drug-interactions-in-geriatric-patients-with-hematologic-malignancy-observational-single-center-study-of-122-patients
#9
David Y Leger, Stephane Moreau, Nicolas Signol, Jean-Baptiste Fargeas, Marie-Agnès Picat, Amélie Penot, Julie Abraham, Marie-Laure Laroche, Dominique Bordessoule
OBJECTIVES: Geriatric patients with hematologic malignancies (HMs) are prescribed targeted and supportive care treatments that add to the preexisting polypharmacy (PP). PP is associated with an increased risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI) resulting in increased hospitalization and mortality in the elderly. As very few data exist on these medication issues in the context of HMs, the objective of this study was to evaluate prevalence of PP, DDI and PIM use at baseline and 3months among elderly patients with HMs who received baseline geriatric assessment...
August 26, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28851471/a-systematic-evaluation-of-impulsive-aggressive-behavior-in-psychogeriatric-inpatients-using-the-staff-observation-aggression-scale-revision-soas-r
#10
Myrella Paschali, Daniel Kamp, Claudia Reichmann, Michaela Jaenner, Christian Lange-Asschenfeldt, Tillmann Supprian
BACKGROUND: Impulsive-aggressive behavior is a significant challenge in geriatric psychiatry and requires professional evaluation and management. METHODS: SOAS-R scales (Staff Observation Aggression Scale-Revision) completed by medical staff on three secure psychiatric wards were analyzed during a period of 12 months. Patients were subdivided into the following two diagnostic subgroups: dementia and other diagnoses. RESULTS: A total of 146 aggressive incidents involving 66 patients were reported (8...
August 30, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28835872/disparities-in-total-hip-arthroplasty-versus-hemiarthroplasty-in-the-management-of-geriatric-femoral-neck-fractures
#11
Sean Dangelmajer, Arthur Yang, Michael Githens, Alex H S Harris, Julius A Bishop
INTRODUCTION: Recent clinical evidence suggests that total hip arthroplasty (THA) provides improved clinical outcomes as compared to hemiarthroplasty (HA) for displaced femoral neck fractures in elderly individuals. However, THA is still utilized relatively infrequently. Few studies have evaluated the factors affecting utilization and the role socioeconomics plays in THA versus HA. METHODS: In the United States, the National Inpatient Sample (NIS) database was used to identify patients treated surgically for femoral neck fracture, between 2009 and 2010...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28831229/baseline-hematology-and-serum-biochemistry-results-for-indian-leopards-panthera-pardus-fusca
#12
Arun Attur Shanmugam, Sanath Krishna Muliya, Ajay Deshmukh, Sujay Suresh, Anukul Nath, Pa Kalaignan, Manjunath Venkataravanappa, Lyju Jose
AIM: The aim of the study was to establish the baseline hematology and serum biochemistry values for Indian leopards (Panthera pardus fusca), and to assess the possible variations in these parameters based on age and gender. MATERIALS AND METHODS: Hemato-biochemical test reports from a total of 83 healthy leopards, carried out as part of routine health evaluation in Bannerghatta Biological Park and Manikdoh Leopard Rescue Center, were used to establish baseline hematology and serum biochemistry parameters for the subspecies...
July 2017: Veterinary World
https://www.readbyqxmd.com/read/28807214/early-geriatric-consultation-increases-adherence-to-tqip-geriatric-trauma-management-guidelines
#13
Lauren T Southerland, Tanya R Gure, Daniel I Ruter, Michael M Li, David C Evans
BACKGROUND: The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. METHODS: This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28790041/impact-of-nutritional-index-on-the-association-between-phosphorus-concentrations-and-mortality-in-haemodialysis-patients-a-cohort-study-from-dialysis-outcomes-and-practice-pattern-study-in-japan
#14
Shingo Fukuma, Tatsuyoshi Ikenoue, Tadao Akizawa, Shunichi Fukuhara
OBJECTIVES: While maintenance of both phosphorus concentration and nutritional status is a major concern in managing haemodialysis patients, the interaction between these parameters is not well understood. The aim of this study was to assess whether or not nutritional index influences the association between phosphorus concentration and all-cause mortality. DESIGN: A cohort study. SETTING: The Dialysis Outcomes and Practice Pattern Study, which included 99 representative dialysis facilities in Japan between 1997 and 2010...
August 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28768325/estimating-risk-of-postsurgical-general-and-geriatric-complications-using-the-vespa-preoperative-tool
#15
Lillian Min, Karen Hall, Emily Finlayson, Michael Englesbe, William Palazzolo, Chiao-Li Chan, Hechuan Hou, Ashley Miller, Kathleen M Diehl
Importance: As greater numbers of older patients seek elective surgery, one approach to preventing postoperative complications is enhanced assessment of risks during preoperative evaluation. Objective: To determine whether a geriatric assessment tool can be implemented in a preoperative clinic and can estimate risk of postoperative complications. Design, Setting, and Participants: In this prospective cohort study, patients 70 years of age or older were assessed in a preoperative clinic for elective surgery from July 9, 2008, to January 5, 2011...
August 2, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28765416/the-physician-s-role-in-perioperative-management-of-older-patients-undergoing-surgery
#16
Adam L Gordon, Barry J Evans, Jugdeep Dhesi
Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28762596/effectiveness-of-home-based-exercise-in-older-patients-with-advanced-chronic-obstructive-pulmonary-disease-a-3-year-cohort-study
#17
Ritsuko Wakabayashi, Yuji Kusunoki, Kumiko Hattori, Takashi Motegi, Ryuko Furutate, Aki Itoh, Rupert Cm Jones, Michael E Hyland, Kozui Kida
AIM: To determine whether home-based exercise can improve clinical outcomes in older patients with advanced chronic obstructive pulmonary disease using long-term oxygen therapy. METHODS: Information was provided to improve chronic obstructive pulmonary disease self-management before the onset of the present prospective 3-year cohort study. Patients selected either home-based exercise using a lower-limb cycle machine (ergo-bicycle; group E), or usual exercise (group U)...
August 1, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28739158/assessment-and-management-of-radiotherapy-induced-toxicity-in-older-patients
#18
Anita O'Donovan, Michelle Leech, Charles Gillham
Radiotherapy is an attractive treatment option for older adults, especially where surgery and chemotherapy pose too great a risk. Radiotherapy toxicity may be divided into acute/early and late effects of treatment. The latter may have limited relevance to an older patient with competing causes of mortality due to significant comorbidity. Altered fractionation regimes have been employed in numerous sites, with no significant toxicity impact. These offer greater convenience in the elderly, especially those with limited social support or in active caregiving roles...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28736876/geriatric-cooperatives-in-southwestern-ontario-a-novel-way-of-increasing-inter-sectoral-partnerships-in-the-care-of-older-adults-with-responsive-behaviours
#19
Iris Gutmanis, Loretta M Hillier
Established in 2010, Geriatric Cooperatives support the evolving Behavioural Supports Ontario (BSO) programme in the South West Local Health Integration Network. Geriatric Cooperatives bring together members representing relevant cross-sectoral services and are tasked with identifying system gaps associated with the BSO target population as well as developing work plans specific to their local area, leveraging local capacity, and co-ordinating and improving linkages between sectors and services. The purpose of this study was to evaluate the partnerships formed over time within these Cooperatives in order to inform their ongoing development and sustainability...
July 24, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28731948/managing-cancer-pain-in-older-adults
#20
Emily J Guerard, James F Cleary
Managing cancer pain in older adults can be complex and challenging. Understanding the unique needs of older patients with cancer is important to safe and effective pain management. The goals of this review are to discuss the assessment of older adults with cancer-related pain, treatment of cancer pain, and adverse effects or potential risks from treatment that are unique to older patients. A detailed pain assessment and when possible utilizing the geriatric assessment are vital to developing a cancer pain management plan...
July 2017: Cancer Journal
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