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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/28498197/overuse-of-health-care-services-in-the-management-of-cancer-a-systematic-review
#1
Shrujal S Baxi, Minal Kale, Salomeh Keyhani, Benjamin R Roman, Annie Yang, Antonio P Derosa, Deborah Korenstein
BACKGROUND: Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. METHODS: We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and 2 grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation's Choosing Wisely initiative in 2012...
May 11, 2017: Medical Care
https://www.readbyqxmd.com/read/28497218/to-evaluate-the-efficacy-of-an-acellular-flowable-matrix-in-comparison-with-a-wet-dressing-for-the-treatment-of-patients-with-diabetic-foot-ulcers-a-randomized-clinical-trial
#2
F Campitiello, M Mancone, A Della Corte, R Guerniero, S Canonico
The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers. Sixty patients with diabetic foot ulcers (Grades 3 Wagner) were included in this randomized clinical trial. The study was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-six cases of diabetic foot ulcers were equally and randomly divided into control and test groups...
May 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28495660/geriatric-patient-safety-indicators-based-on-linked-administrative-health-data-to-assess-anticoagulant-related-thromboembolic-and-hemorrhagic-adverse-events-in-older-inpatients-a-study-proposal
#3
Marie-Annick Le Pogam, Catherine Quantin, Oliver Reich, Philippe Tuppin, Anne Fagot-Campagna, Fred Paccaud, Isabelle Peytremann-Bridevaux, Bernard Burnand
BACKGROUND: Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide...
May 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28493898/apathy-but-not-depression-is-associated-with-executive-dysfunction-in-cerebral-small-vessel-disease
#4
Valerie Lohner, Rebecca L Brookes, Matthew J Hollocks, Robin G Morris, Hugh S Markus
OBJECTIVE: To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD), and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed. METHODS: 196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation...
2017: PloS One
https://www.readbyqxmd.com/read/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#5
Mary E Anderson, Kelly Mcdevitt, Ethan Cumbler, Heather Bennett, Zachary Robison, Bryan Gomez, Jason W Stoneback
CONTEXT: Fragmentation in geriatric hip fracture care is a growing concern because of the aging population. Patients with hip fractures at our institution historically were admitted to multiple different services and units, leading to unnecessary variation in inpatient care. Such inconsistency contributed to delays in surgery, discharge, and functional recovery; hospital-acquired complications; failure to adhere to best practices in osteoporosis management; and poor coordination with outpatient practitioners...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28483663/e-r-a-s-pathway-in-colorectal-surgery-in-elderly-our-experience
#6
Basilio Pirrera, Andrea Lucchi, Carlo Gabbianelli, Vincenzo Alagna, Giacomo Martorelli, Pierluigi Berti, Ilaria Panzini, Elisabetta Fabbri, Gianluca Garulli
AIM: Numerous geriatric patients develop colorectal disease. Elderly patients are often considered high-risk surgical candidates. Enhanced recovery after surgery (E.R.A.S.) has been proven to be beneficial for patients. The aim of the study was to evaluate the results of an ERAS protocol in older patients that underwent colorectal surgery compared to younger patients. METHOD: In the period between January 2010 to December 2015 a total of 589 patients underwent elective colorectal surgical interventions treated within the E...
May 5, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28471943/clinical-implications-of-aging-with-hiv-infection-perspectives-and-the-future-medical-care-agenda
#7
Giovanni Guaraldi, Frank J Palella
: The increasing number of aging HIV-infected (HIV+) persons comprises a unique population at risk for illnesses and syndromes traditionally associated with the elderly. As a result, similar to the current need for primary care providers to manage chronic noninfectious comorbidities among aging persons with well controlled HIV infection, HIV clinical care will need to routinely involve geriatric medicine in a new HIV-geriatric discipline. The objective of this article is to provide a conceptual framework in which HIV and geriatric management considerations for healthcare professionals caring for HIV+ persons are integrated...
June 1, 2017: AIDS
https://www.readbyqxmd.com/read/28436194/impact-of-living-arrangements-on-clinical-outcomes-among-older-patients-with-dementia-or-cognitive-impairment-admitted-to-the-geriatric-evaluation-and-management-unit-in-taiwan
#8
Cheng-Hao Hung, Ting-Ching Tang, Chih-Jen Wang, Li-Kuo Liu, Li-Ning Peng, Liang-Kung Chen
AIM: To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. METHODS: The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436184/delaying-cognitive-and-physical-decline-through-multidomain-interventions-for-residents-with-mild-to-moderate-dementia-in-dementia-care-units-in-taiwan-a-prospective-cohort-study
#9
Chih-Kuang Liang, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Shih-Yi Lin, Liang-Kung Chen, Yu-Te Lin, Tsung-Yun Liu, Ching-Hui Loh
AIM: To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. METHODS: Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic)...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28433847/is-it-reliable-to-predict-the-outcome-of-elderly-patients-with-severe-traumatic-brain-injury-using-impact-prognostic-calculator
#10
Xueyan Wan, Kai Zhao, Sheng Wang, Huaqiu Zhang, Liang Zeng, Yu Wang, Lin Han, Rajluxmee Beejadhursing, Kai Shu, Ting Lei
BACKGROUND: Many investigators endeavor to predict the outcome based on admission characteristics using some established models to determine which management should be applied. However, the efficacy and applicability of the models using in the geriatric severe traumatic brain injury (TBI) patients have not been evaluated yet. METHODS: 137 geriatric severe TBI patients were enrolled in this retrospective study. Receiver operating characteristics (ROC) curves were constructed to evaluate the efficacy and usability of the IMPACT prognostic model in evaluating the prognosis for these patients...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#11
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28413223/chiropractic-management-of-a-geriatric-patient-with-idiopathic-neuralgic-amyotrophy-a-case-report
#12
Jordan Gliedt, Justin M Goehl, Derek P Smith, Clinton J Daniels
OBJECTIVE: The purpose of this paper is to describe chiropractic management of a patient with neuralgic amyotrophy (NA) and to provide discussion regarding presentation, differential diagnosis, management and prognosis of idiopathic NA. CASE PRESENTATION: An 85 year old Caucasian male presented to a chiropractic clinic with right periscapular and lateral rib cage pain. The patient had previously sought evaluation and treatment from multiple health care providers and underwent multiple interventions without relief...
March 2017: Journal of the Canadian Chiropractic Association
https://www.readbyqxmd.com/read/28411479/aged-patients-with-metastatic-castration-resistant-prostate-cancer-should-we-treat-with-chemotherapy
#13
REVIEW
Miguel Ángel Climent, Ma Dolores Torregrosa, Sergio Vázquez, Regina Gironés, José Angel Arranz
Prostate cancer largely affects aged men and as life expectancy continues to increase, it is likely to be a growing burden requiring an adequate management. Aging is a heterogeneous process, thus, to assess the individual state of health when making decisions is essential. Comprehensive geriatric assessment allows a detailed evaluation of the state of health of a specific subject and can modify the therapeutic decision. It is still not commonly used because it is time consuming. Chemotherapy should be administered equally in aged well-fit patients as in the general population as per the SIOG (International society of geriatric oncology) recommendations for geriatric evaluation and treatment in prostate cancer patients...
April 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28410002/comparing-behavioral-health-models-for-reducing-risky-drinking-among-older-male-veterans
#14
Nikki R Wooten, Abbas S Tavakoli, Marlene B Al-Barwani, Naomi A Thomas, Hrishikesh Chakraborty, Anna M Scheyett, Kelly M Kaminski, Alyssia C Woods, Sue E Levkoff
BACKGROUND: Screening older veterans in Veterans Affairs Medical Center (VAMC) primary care clinics for risky drinking facilitates early identification and referral to treatment. OBJECTIVE: This study compared two behavioral health models, integrated care (a standardized brief alcohol intervention co-located in primary care clinics) and enhanced referral care (referral to specialty mental health or substance abuse clinics), for reducing risky drinking among older male VAMC primary care patients...
April 14, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28401631/disease-burden-comorbidity-and-geriatric-syndromes-in-the-australian-aged-care-population
#15
Jodie Belinda Hillen, Agnes Vitry, Gillian E Caughey
OBJECTIVE: To describe the burden of disease in the Australian residential aged care population. METHODS: Cross-sectional analysis of Aged Care Funding Instrument data. RESULTS: Dementia (48%), depression (22.5%) and arthritis (14.2%) were the most prevalent chronic diseases in this population. Unclassified conditions such as falls, pain and urinary incontinence were also significant burdens in this population (17.1%). Circulatory, musculoskeletal and unclassified conditions were the most prevalent comorbidities across all common medical groups...
April 11, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28399219/a-multidisciplinary-intervention-to-prevent-subsequent-falls-and-health-service-use-following-fall-related-paramedic-care-a-randomised-controlled-trial
#16
A Stefanie Mikolaizak, Stephen R Lord, Anne Tiedemann, Paul Simpson, Gideon A Caplan, Jason Bendall, Kirsten Howard, Lyndell Webster, Narelle Payne, Sarah Hamilton, Joanne Lo, Elisabeth Ramsay, Sandra O'Rourke, Linda Roylance, J C Close
Background: approximately 25% of older people who fall and receive paramedic care are not subsequently transported to an emergency department (ED). These people are at high risk of future falls, unplanned healthcare use and poor health outcomes. Objective: to evaluate the impact of a fall-risk assessment and tailored fall prevention interventions among older community-dwellers not transported to ED following a fall on subsequent falls and health service use. Design, setting, participants: Randomised controlled trial involving 221 non-transported older fallers from Sydney, Australia...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28392681/psychometric-properties-of-the-persian-version-of-social-adaptation-self-evaluation-scale-in-community-dwelling-older-adults
#17
Pouya Farokhnezhad Afshar, Mahshid Foroughan, AbouAli Vedadhir, Mahmood Ghazi Tabatabaie
INTRODUCTION: The Social Adaptation Self-evaluation Scale (SASS) is used to measure social function and social motivation in depressed patients. There is little attention to social function in the treatment of depression. The aim of this study was to assess the validity and reliability of the Persian version of SASS (P-SASS) for older adults. PARTICIPANTS AND METHODS: This is a cross-sectional and methodological study. The participants were 550 community-dwelling older adults living in Tehran who were selected randomly from the primary health care centers...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28392431/-urinary-catheters-prevalence-study-in-a-university-hospital
#18
J Carrouget, C Legeay, A Poirier, A-R Azzouzi, J-R Zahar, P Bigot
INTRODUCTION: Urinary tract infection is the most common healthcare-association infection, especially because of urinary catheter. We evaluated our practices concerning catheter insertion and management in our institution. MATERIALS AND METHODS: We conducted a single-centre descriptive cross-sectional study during 1 week in September 2014 in all adult departments. We noted prevalence, indications, length, management of urinary catheter (UC) and symptomatic catheter-associated urinary tract infections (SCAUTI)...
April 6, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28388276/a-formative-evaluation-of-a-nurse-practitioner-led-interprofessional-geriatric-outpatient-clinic
#19
Kevin T Hansen, Cheryl McDonald, Sue O'Hara, Leslie Post, Susan Silcox, Iris A Gutmanis
The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic)...
April 7, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28376985/a-clinical-review-of-surgical-vs-transcatheter-aortic-valve-replacement-in-geriatric-patients
#20
Laura V Tsu, Andrew J Berry, Neda Krunic, Sarah Penny, Sonny Le
OBJECTIVE: To provide an up-to-date review of the available evidence regarding management of elderly patients after transcatheter aortic valve replacement (TAVR). DATA SOURCES: A PubMed search of articles published (September 1969-December 2016) was done using a combination of the following words: aortic valve stenosis, geriatric, elderly, transcatheter aortic valve replacement, surgical aortic valve replacement, transcatheter aortic valve implantation (TAVI), and dual antiplatelet therapy...
April 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
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