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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/28089304/management-of-prostate-cancer-in-elderly-patients-recommendations-of-a-task-force-of-the-international-society-of-geriatric-oncology
#1
REVIEW
Jean-Pierre Droz, Gilles Albrand, Silke Gillessen, Simon Hughes, Nicolas Mottet, Stéphane Oudard, Heather Payne, Martine Puts, Gilbert Zulian, Lodovico Balducci, Matti Aapro
CONTEXT: Prostate cancer is the most frequent male cancer. Since the median age of diagnosis is 66 yr, many patients require both geriatric and urologic evaluation if treatment is to be tailored to individual circumstances including comorbidities and frailty. OBJECTIVE: To update the 2014 International Society of Geriatric Oncology (SIOG) guidelines on prostate cancer in men aged >70 yr. The update includes new material on health status evaluation and the treatment of localised, advanced, and castrate-resistant disease...
January 11, 2017: European Urology
https://www.readbyqxmd.com/read/28074747/liraglutide-a-glucagon-like-peptide-1-agonist-for-chronic-weight-management
#2
Kendra R Manigault, Maria Miller Thurston
OBJECTIVE: To review the efficacy and safety of liraglutide 3.0 mg for weight loss. DATA SOURCE: A literature search was performed using PubMed and MEDLINE from 2000 to 2016. The following key terms were used alone or in combination: glucagon-like peptide-1 agonist, liraglutide, obesity, overweight, and weight loss. Additional supporting literature was identified utilizing the reference lists of the preceding articles. STUDY SELECTION: Analyzed studies were published in English and investigated use of liraglutide and its impact on weight loss...
December 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28061830/age-nutrition-chirugie-anc-study-impact-of-a-geriatric-intervention-on-the-screening-and-management-of-undernutrition-in-elderly-patients-operated-on-for-colon-cancer-a-stepped-wedge-controlled-trial
#3
Marine Dupuis, Elisabetta Kuczewski, Laurent Villeneuve, Sylvie Bin-Dorel, Max Haine, Claire Falandry, Thomas Gilbert, Guillaume Passot, Olivier Glehen, Marc Bonnefoy
BACKGROUND: Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. METHODS/DESIGN: The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design...
January 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28053513/metastatic-castration-resistant-prostate-cancer-in-very-elderly-patients-challenges-and-solutions
#4
REVIEW
Orazio Caffo, Francesca Maines, Mimma Rizzo, Stefania Kinspergher, Antonello Veccia
The treatment of elderly patients with cancer is usually viewed by clinicians as a challenge, because of the age-related decline in normal organ function and the frequent concomitant administration of multiple drugs for comorbid conditions. Clinicians therefore tend not to prescribe antineoplastic agents (mainly in the case of chemotherapy) to elderly patients, with the fear of excess toxicity leading to an unfavorable cost:benefit ratio. The cutoff age defining a cancer patient as elderly is usually 70 years, but over the last 10 years clinicians have paid more attention to functional status, as evaluated by means of a comprehensive geriatric assessment and comorbidity burden, rather than chronological age...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28025357/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-xii-leg-length-discrepancy
#5
Mark Havran, Joel D Scholten, Paula Breuer, Jennifer Lundberg, Gary Kochersberger, Dave Newman, Debra K Weiner
 To present the last in a 12-part series designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on leg length discrepancy (LLD) and presents an algorithm outlining approaches to diagnosis and management of LLD in older adults, along with a representative clinical case. METHODS : Using a modified Delphi approach, the LLD evaluation and treatment algorithm was developed by a multidisciplinary expert panel representing expertise in physical therapy, geriatric medicine, and physical medicine and rehabilitation...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27994004/biological-aging-and-the-future-of-geriatric-psychiatry
#6
REVIEW
Bret R Rutherford, Warren D Taylor, Patrick J Brown, Joel R Sneed, Steven P Roose
Advances in understanding the biological bases of aging have intellectually revitalized the field of geriatric psychiatry and broadened its scope to include promoting successful aging and studying resilience factors in older adults. To describe the process by which this paradigm shift has occurred and illustrate its implications for treatment and research of late-life brain disorders, late-life depression is discussed as a prototype case. Prior phases of geriatric psychiatry research were focused on achieving depressive symptom relief, outlining pharmacokinetic and pharmacodynamic differences between older and younger adults, and identifying moderators of treatment response...
December 18, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/27988927/cardiac-remodelling-in-a-baboon-model-of-intrauterine-growth-restriction-mimics-accelerated-ageing
#7
Anderson H Kuo, Cun Li, Jinqi Li, Hillary F Huber, Peter W Nathanielsz, Geoffrey D Clarke
KEY POINTS: Rodent models of intrauterine growth restriction (IUGR) successfully identify mechanisms that can lead to short-term and long-term detrimental cardiomyopathies but differences between rodent and human cardiac physiology and placental-fetal development indicate a need for models in precocial species for translation to human development. We developed a baboon model for IUGR studies using a moderate 30% global calorie restriction of pregnant mothers and used cardiac magnetic resonance imaging to evaluate offspring heart function in early adulthood...
November 6, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27965770/the-geriatric-asthma-pitfalls-and-challenges
#8
REVIEW
Alida Benfante, Nicola Scichilone
Historically, asthma has been envisioned as a disease of younger ages. This has led to the assumption that respiratory symptoms suggestive of asthma occurring in older ages are to be attributed to conditions other than asthma, mainly COPD. Old observational reports and new epidemiological studies confirm that asthma is as frequent in older as it is in younger populations. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. The characterization of asthma in the aged suffers from the fact that there has been very little original research in this field...
2016: Asthma research and practice
https://www.readbyqxmd.com/read/27935182/pain-management-intervention-targeting-nursing-staff-and-general-practitioners-pain-intensity-consequences-and-clinical-relevance-for-nursing-home-residents
#9
Dagmar Dräger, Andrea Budnick, Ronny Kuhnert, Sonja Kalinowski, Franziska Könner, Reinhold Kreutz
AIM: Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany. METHODS: In a cluster-randomized controlled intervention, 195 residents of 12 Berlin nursing homes who were affected by pain were surveyed at three points of measurement...
December 9, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27925292/cognitive-impairment-in-parkinson-s-disease-impact-on-quality-of-life-of-carers
#10
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
#11
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...
March 2017: 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
#12
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
#13
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...
January 2017: Headache
https://www.readbyqxmd.com/read/27895425/folfirinox-in-elderly-patients-with-pancreatic-or-colorectal-cancer-tolerance-and-efficacy
#14
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
#15
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
#16
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
#17
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
#18
R Stauder, B Eichhorst, M E Hamaker, K Kaplanov, V A 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 > 70 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
#19
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...
December 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27785425/how-to-optimally-manage-elderly-bladder-cancer-patients
#20
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
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