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Geriatric evaluation and management

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https://www.readbyqxmd.com/read/28302309/best-practices-for-chiropractic-care-for-older-adults-a-systematic-review-and-consensus-update
#1
Cheryl Hawk, Michael J Schneider, Mitchell Haas, Paul Katz, Paul Dougherty, Brian Gleberzon, Lisa Z Killinger, John Weeks
OBJECTIVE: The purpose of this study was to update evidence-based recommendations on the best practices for chiropractic care of older adults. METHODS: The project consisted of a systematic literature review and a consensus process. The following were searched from October 2009 through January 2016: MEDLINE, Index to Chiropractic Literature, CINAHL (Cumulative Index to Nursing and Allied Health Literature), AMED (Allied and Complementary Medicine Database), Alt HealthWatch, Cochrane Database of Systematic Reviews, and Cochrane Registry of Controlled Trials...
March 14, 2017: Journal of Manipulative and Physiological Therapeutics
https://www.readbyqxmd.com/read/28292582/-profile-and-evolution-of-chronic-complex-patients-in-a-subacute-unit
#2
Neus Gual, Anna Yuste Font, Belen Enfedaque Montes, Carles Blay Pueyo, Remedios Martín Álvarez, Marco Inzitari
OBJECTIVE: To improve the management of geriatric pluripathologic patients in Catalonia, the identification of chronic complex patient (PCC) or patients with advanced chronic disease (MACA) has been promoted. Patients with exacerbated chronic diseases are promoted to be admitted in subacute units (SG) located in intermediate hospitals and specialized in geriatric care, as an alternative to acute hospital. The results of the care process in patients identified as PCC/MACA in SG have not been evaluated...
March 11, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28289356/management-of-burns-in-the-elderly
#3
G S Abu-Sittah, F M Chahine, H Janom
Burns are one of the most devastating forms of trauma worldwide. While geriatric burns are uncommon in the developing world - accounting for less than 5% of burns in South Asian and Middle Eastern countries - they account for almost 20% of burns in economically developed countries such as the USA. The elderly population in general is at higher risk for burn injury, moreover mortality rate, as well as severity of complications, is more pronounced in this group of patients. A review of the literature was conducted to evaluate risk factors as well as pathophysiological and immunological conditions that affect response to burn injury in the elderly population...
December 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28279473/issues-in-the-management-of-esophagogastric-cancer-in-geriatric-patients
#4
REVIEW
Elizabeth Won
Esophagogastric cancers predominantly affect older adults; however, older patients are less likely to be recommended for both curative and palliative treatment. Older patients have unique challenges that need to be addressed during their oncologic care. Tools such as complete geriatric assessments may help to better identify fit older adults and stratify patients for aggressive treatment strategies. This review evaluates the current knowledge and the remaining challenges in optimally managing elderly patients with esophagogastric cancers...
April 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28244583/the-application-of-the-diagnostic-therapeutic-care-pathway-for-the-geriatric-patient-with-anemia-at-the-hospital-of-cosenza-italy-a-management-tool-or-a-quality-project
#5
M Loizzo, O Cuccurullo, F Gallo
BACKGROUND: Many studies in literature, indicate that the prognosis of hospitalized elderly patients is substantially related to the presence of concomitant diseases (multi-morbidity) along with physical, cognitive, biological and social functional impairments. These patients, therefore, require the expertise of a multi-professional and multi-disciplinary team operating in a Multi Dimensional Rating (MDR). MDR explores the multiple facets of the elderly and it is considered the tool of choice to define prognosis, especially in the case of compromised elderly patients with clinical or functional problems...
March 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28244024/-geriatric-inpatients-with-iron-deficiency-associated-restless-legs-syndrome-a-retrospective-analysis
#6
Benjamin Lieske, Gabriele Röhrig, Ingrid Becker, Ralf-Joachim Schulz, Maria Cristina Polidori, Jan Kassubek
OBJECTIVE: The Restless Legs Syndrome (RLS) is a clinically relevant condition in geriatric patients. An association between iron deficiency and RLS is largely acknowledged. The clinical and therapeutic management of iron deficiency-associated RLS has been, however, poorly evaluated in geriatric patients. METHODS: Data from all RLS inpatients admitted to a geriatric unit between 2009 and 2011 were retrospectively collected on demographics and clinical characteristics, iron status, drug treatment including iron substitution, as well as comprehensive geriatric assessment (CGA) scores...
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28238154/the-gestio-protocol-experience-safety-of-a-standardized-order-set-for-subcutaneous-insulin-regimen-in-elderly-hospitalized-patients
#7
Alessandro Franchin, Alberto Maran, Daniela Bruttomesso, Maria L Corradin, Francesco Rossi, Federica Zanatta, Gian-Maria Barbato, Nicola Sicolo, Enzo Manzato
BACKGROUNDS: In non-critical hospitalized patients with diabetes mellitus, guidelines suggest subcutaneous insulin therapy with basal-bolus regimen, even in old and vulnerable inpatients. AIM: To evaluate safety, efficacy, and benefit on clinical management of the GesTIO protocol, a set of subcutaneous insulin administration rules, in old and vulnerable non-ICU inpatients. METHODS: Retrospective, observational study. Patients admitted to Geriatric Clinic of Padua were studied...
February 25, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28224693/analysis-of-team-types-based-on-collaborative-relationships-among-doctors-home-visiting-nurses-and-care-managers-for-effective-support-of-patients-in-end-of-life-home-care
#8
Junko Fujita, Sakiko Fukui, Sumie Ikezaki, Chizuru Otoguro, Mayuko Tsujimura
AIM: To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. METHODS: A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis...
February 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28214764/recurrent-falls-and-its-risk-factors-among-older-men-living-in-the-veterans-retirement-communities-a-cross-sectional-study
#9
Cheng-Hao Hung, Chih-Jen Wang, Ting-Ching Tang, Liang-Yu Chen, Li-Ning Peng, Fei-Yuan Hsiao, Liang-Kung Chen
AIM: To evaluate the prevalence of recurrent falls and their risk factors among older men living in the Veterans Homes in Taiwan. METHODS: This cross-sectional study enrolled 871 residents and all participants received the comprehensive geriatric assessment, including Barthel Index, Mini-Mental Status Examination (MMSE), Geriatric Depression Scale-5 questions (GDS-5), Mini-Nutrition Assessment Short Form (MNA-SF), the status of urinary incontinence, stool incontinence, polypharmacy, past history of falls, multimorbidity, and medication history...
May 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28194812/detection-and-management-of-hyperactive-and-hypoactive-delirium-in-older-patients-during-hospitalization-a-retrospective-cohort-study-evaluating-daily-practice
#10
Eveline L van Velthuijsen, Sandra M G Zwakhalen, Wubbo J Mulder, Frans R J Verhey, Gertrudis I J M Kempen
OBJECTIVES: The objectives of the study are to study daily hospital practice regarding detection and management and to study hyperactive and hypoactive delirium of older patients during their hospitalization. METHODS: A retrospective cohort study evaluating care as usual for older hospitalized patients with delirium at Maastricht University Medical Center+, a university hospital in the Netherlands, was performed. Inclusion criteria were older hospitalized patients (65+ years), diagnosed with delirium between 1 January and 31 December 2014...
February 14, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28156541/contribution-of-polypharmacy-and-potentially-inappropriate-medication-use-to-inferior-survival-in-older-patients-with-aggressive-lymphoma
#11
Robin Guo, Daniel Jacob Becker, Michael L Grossbard, Catherine S Magid Diefenbach
129 Background: Survival outcomes for older patients with aggressive non-Hodgkin's lymphoma (NHL) are disproportionally inferior to those of younger patients. While differences in tumor biology may play a role, older patients are often frail with comorbidities, polypharmacy, and use potentially inappropriate medications (PIM). METHODS: Using Cox proportional hazard and logistic regression models, we retrospectively analyzed all aggressive NHL patients age 60 and older diagnosed and treated at our institution from 2009-2014 to examine the effect of polypharmacy and PIM use on progression-free survival (PFS), overall survival (OS), and treatment-related toxicities...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28131609/geriatric-syncope-and-cardiovascular-risk-in-the-emergency-department
#12
Nissa J Ali, Shamai A Grossman
BACKGROUND: Syncope is a transient loss of consciousness that is caused by a brief loss in generalized cerebral blood flow. OBJECTIVE: This article reviews the background, epidemiology, etiologies, evaluation, and disposition considerations of geriatric patients with syncope, with a focus on cardiovascular risk. DISCUSSION: Although syncope is one of the most common symptoms in elderly patients presenting to the emergency department, syncope causes in geriatric patients can present differently than in younger populations, and the underlying etiology is often challenging to discern...
January 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28130953/primary-care-collaborative-memory-clinics-building-capacity-for-optimized-dementia-care
#13
Linda Lee, Loretta M Hillier, Frank Molnar, Michael J Borrie
Increasingly, primary care collaborative memory clinics (PCCMCs) are being established to build capacity for person-centred dementia care. This paper reflects on the significance of PCCMCs within the system of care for older adults, supported with data from ongoing evaluation studies. Results highlight timelier access to assessment with a high proportion of patients being managed in primary care within a person-centred approach to care. Enhancing primary care capacity for dementia care with interprofessional and collaborative care will strengthen the system's ability to respond to increasing demands for service and mitigate the growth of wait times to access geriatric specialist assessment...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28130822/the-role-of-social-relationships-among-elderly-community-dwelling-and-nursing-home-residents-findings-from-a-quality-of-life-study
#14
Paolo Scocco, Mario Nassuato
AIM: In Western countries, older adults' needs are often managed through institutionalization. Based on the assumption that quality of life, particularly social relationships, may be perceived differently according to residential setting, the aims of this study were to compare World Health Organization Quality of Life brief version (WHOQOL-BREF) scores of elderly community-dwelling residents and nursing home residents. METHODS: A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated with Mini-Mental State Examination (MMSE), WHOQOL-BREF, and Geriatric Depression Scale (GDS)...
January 28, 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/28117544/specialist-care-of-older-adults-with-hiv-infection-in-the-uk-a-service-evaluation
#15
F V Cresswell, T Levett
OBJECTIVES: There is a clear trajectory towards cohort ageing in the UK. HIV infection is associated with an increased prevalence of traditionally age-related comorbidities and geriatric syndromes. Some HIV services have been proactive in innovating models that cater for adapting needs. We aimed to describe how widespread this practice is and what form such services take. METHODS: We conducted an evaluation of the perceived need for and current provision of specialist ageing services, and the need for formal guidance on monitoring or treatment of older adults with HIV infection...
January 24, 2017: HIV Medicine
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
#16
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
#17
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
#18
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
#19
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
#20
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
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