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https://www.readbyqxmd.com/read/28731943/the-impact-of-polypharmacy-on-patient-outcomes-in-older-adults-with-cancer
#1
Ginah Nightingale, Emily Skonecki, Manpreet K Boparai
Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28728745/early-readmissions-after-acute-myocardial-infarction
#2
Chun Shing Kwok, Chun Wai Wong, Hannah Shufflebotham, Luke Brindley, Tamseel Fatima, Adrian Shufflebotham, Diane Barker, Ashish Pawala, Grant Heatlie, Mamas A Mamas
This study aims to evaluate the rate, predictors, and causes of 30-day readmissions in a single tertiary hospital in the United Kingdom. We conducted a retrospective study of all patients admitted between 2012 and 2014 with a diagnosis of acute myocardial infarction, who were in the Myocardial Infarction National Audit Project register. Data on patient demographics, comorbidities, care received, and in-hospital mortality were collected. Rates of 30-day readmission and causes of readmission were evaluated. Univariate and multiple logistic regressions were used to identify predictors of all-cause, cardiac, and noncardiac readmission...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28725985/diversity-in-fall-characteristics-hampers-effective-prevention-the-precipitants-the-environment-the-fall-and-the-injury
#3
K M Sanders, K Lim, A L Stuart, A Macleod, D Scott, G C Nicholson, L Busija
Falls among the elderly are common and characteristics may differ between injurious and non-injurious falls. Among 887 older Australian women followed for 1.6 years, 32% fell annually. Only 8.5% resulted in fracture and/or hospital admission. The characteristics of those falls are indistinguishable from those not coming to medical attention. INTRODUCTION: The precipitants and environment of all falls occurring among a large cohort of older Caucasian women were categorised by injury status to determine if the characteristics differed between injurious and non-injurious falls...
July 19, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28723702/reducing-falls-in-the-inpatient-hospital-setting
#4
Catherine M Melin
AIM: This quality improvement project's objective was to introduce and assess a process change to potentially reduce fall rates on an inpatient medical-surgical unit. METHODS: The Iowa Model of Evidence-Based Practice was used to guide the implementation of this project. This project was piloted over a 3-month period from October to December 2016 on a 38-bed medical-surgical unit at a community-based hospital in the southeastern United States. Prior to the implementation of this quality improvement project, staff received falls education using a modified pre-existing falls prevention protocol, with a focus on increasing the consistency of bed/chair alarm use for patients identified as being at risk for falling...
July 18, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28723244/evaluation-of-the-national-health-service-nhs-direct-pilot-telehealth-program-cost-effectiveness-analysis
#5
Malcolm Clarke, Joanna Fursse, Nancy Connolly, Urvashi Sharma, Russell Jones
OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program...
July 18, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28721026/a-community-virtual-ward-model-to-support-older-persons-with-complex-health-care-and-social-care-needs
#6
C Lewis, Z Moore, F Doyle, A Martin, D Patton, L E Nugent
BACKGROUND: Globally the older population is increasing rapidly. As a result there is an increase in frail older persons living within the community, with increased risks of a hospital admission and higher mortality and morbidity rates. Due to complexity of care, health care professionals face challenges in providing effective case management and avoiding unplanned admissions to hospital. A community virtual ward (CVW) model was developed to assist health care professionals to support older persons at home during periods of illness and/or functional decline...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28720613/retrospective-analysis-of-newly-recorded-certifications-of-visual-impairment-due-to-diabetic-retinopathy-in-wales-during-2007-2015
#7
Rebecca L Thomas, Stephen D Luzio, Rachel V North, Sanjiv Banerjee, Antra Zekite, Catey Bunce, David R Owens
OBJECTIVE: The aim of this study was to analyse the changes in new certifications for both sight impairment (SI) and severe sight impairment (SSI, blindness) in Wales due to diabetic retinopathy (DR)/maculopathy between 2007 and 2015. RESEARCH DESIGN AND METHODS: This is a retrospective analysis of annual data of new certifications for visual impairment and blindness (Certificate of Vision Impairment) for England and Wales derived from the national database provided by the Certifications Office, Moorfields Eye Hospital, over a period of 8 years from 2007...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28719088/understanding-and-managing-the-risk-of-head-impact-from-in-hospital-falls-a-cross-sectional-analysis-of-data-from-166-public-hospitals
#8
Satyan R Chari, Paul Varghese, Rebecca A R Bell, Kate Smith, Terry P Haines
BACKGROUND: Falls are a leading cause of preventable harm in the hospitalized elderly, and head impacts (HIs) can be a precursor to serious injury. The aim of this study was to examine if the risk of fall-related HI can be explained by incident characteristics. METHODS: All reported falls across public hospital facilities in the state of Queensland, Australia, over a 2-year period were analyzed using univariate and multiple logistic regression. RESULTS: In all, 650 instances of HI were reported across 24 218 falls...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28718704/a-study-of-sports-related-orbital-fractures-in-singapore
#9
Jing Zhan Lock, Raghuraj Hegde, Stephanie Young, Thiam Chye Lim, Shantha Amrith, Gangadhara Sundar
With an increased popularity of sport and active living worldwide, our study aims to explore the incidence and features of sports-related orbital fractures in Singapore. 1421 computer tomography (CT) imaging scans of the face and orbits done at the National University Hospital over a 24-month period from January 2013 and December 2014 were reviewed retrospectively for orbital fractures. We identified 483 orbital fractures of which sports injury was the fourth most common etiology (n = 65; 13.5%) after road traffic accident (n = 131; 27...
July 18, 2017: Orbit
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#10
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28717892/a-population-based-study-of-injuries-to-the-brachial-plexus-and-to-the-peripheral-nerves-of-the-shoulder-girdle-and-upper-limb-in-the-italian-region-friuli-venezia-giulia
#11
Francesca Valent, Roberto Eleopra, Paolo Manganotti, Paolo Passadore
The aim of this study was to estimate the incidence, identify the causes, and explore treatments of the injuries to the brachial plexus and peripheral nerves of the shoulder girdle and upper limb in the 1,220,000-inhabitant Italian region Friuli Venezia Giulia.We linked at the individual patient level various administrative databases using an anonymous stochastic key: list of residents, hospital discharge, emergency department, and outpatient care prescriptions database. We abstracted hospital discharge records with at least one discharge diagnosis code ICD-9-CM 953...
July 17, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28716041/potentially-inappropriate-home-medications-among-older-patients-with-cardiovascular-disease-admitted-to-a-cardiology-service-in-usa
#12
Marwan Sheikh-Taha, Hani Dimassi
BACKGROUND: The use of potentially inappropriate medications (PIMs) may pose more risks than benefits to patients and is a major factor contributing to the likelihood of serious adverse drug reactions and negative health outcomes among older patients. METHODS: A retrospective chart review was conducted in a tertiary care center in USA where home medications of the older patients were reviewed and analyzed upon hospital admission over three months, from March till May 2016...
July 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28716004/concurrent-use-of-alcohol-interactive-medications-and-alcohol-in-older-adults-a-systematic-review-of-prevalence-and-associated-adverse-outcomes
#13
Alice E Holton, Paul Gallagher, Tom Fahey, Gráinne Cousins
BACKGROUND: Older adults are susceptible to adverse effects from the concurrent use of medications and alcohol. The aim of this study was to systematically review the prevalence of concurrent use of alcohol and alcohol-interactive (AI) medicines in older adults and associated adverse outcomes. METHODS: A systematic search was performed using MEDLINE (PubMed), Embase, Scopus and Web of Science (January 1990 to June 2016), and hand searching references of retrieved articles...
July 17, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28714913/novel-fri1-like-viruses-infecting-acinetobacter-baumannii-vb_abap_as11-and-vb_abap_as12-characterization-comparative-genomic-analysis-and-host-recognition-strategy
#14
Anastasia V Popova, Daria G Lavysh, Evgeniy I Klimuk, Mikhail V Edelstein, Alexander G Bogun, Mikhail M Shneider, Artemiy E Goncharov, Sergey V Leonov, Konstantin V Severinov
Acinetobacter baumannii is a gram-negative, non-fermenting aerobic bacterium which is often associated with hospital-acquired infections and known for its ability to develop resistance to antibiotics, form biofilms, and survive for long periods in hospital environments. In this study, we present two novel viruses, vB_AbaP_AS11 and vB_AbaP_AS12, specifically infecting and lysing distinct multidrug-resistant clinical A. baumannii strains with K19 and K27 capsular polysaccharide structures, respectively. Both phages demonstrate rapid adsorption, short latent periods, and high burst sizes in one-step growth experiments...
July 17, 2017: Viruses
https://www.readbyqxmd.com/read/28713844/epidemiology-diagnosis-and-management-of-neurogenic-orthostatic-hypotension
#15
Jose-Alberto Palma, Horacio Kaufmann
BACKGROUND: Orthostatic hypotension (OH) is a sustained fall in blood pressure on standing which can cause symptoms of organ hypoperfusion. OH is associated with increased morbidity and mortality and leads to a significant number of hospital admissions particularly in the elderly (233 per 100,000 patients over 75 years of age in the US). OH can be due to volume depletion, blood loss, large varicose veins, medications, or due to defective activation of sympathetic nerves and reduced norepinephrine release upon standing (i...
May 2017: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/28710719/fragility-fractures-at-auckland-city-hospital-we-can-do-better
#16
Geoffrey Braatvedt, Susan Wilkinson, Marilyn Scott, Paul Mitchell, Roger Harris
This study describes in detail the burden of caring for patients aged ≥ 50 years seen in one year with a fragility fracture in a large urban environment and shows that these fractures result in a long length of stay and significant mortality. Intervention to prevent further fracture was poorly done. PURPOSE: To examine the epidemiology of fragility fracture in patients over age 50 years and record the number who received appropriate secondary prevention treatment. METHODS: All patients aged ≥ 50 years presenting with a fracture during the 12 months following July 1(st) 2011, to Auckland City Hospital or residing in central Auckland at the time of their fracture, were identified from hospital and Accident Compensation Corporation records...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28707131/posterior-locked-lateral-compression-injury-of-the-pelvis-in-geriatric-patients-an-infrequent-and-specific-variant-of-the-fragility-fracture-of-pelvis
#17
Se-Won Lee, Weon-Yoo Kim, Sung-Jun Koh, Young-Yul Kim
INTRODUCTION: Posterior locked lateral compression injury (PLLCI) of the pelvic ring is an infrequent variant of lateral compression injury, a condition described in only eight reported cases since 2000. Lateral compression injury usually results from high-energy trauma and is characterized by locking between the medially translated fractured ilium and the anterior border of the sacrum, regardless of whether the fractured ilium involves the sacroiliac joint. However, in our experience, lateral compression injury can also result from low-energy trauma as a manifestation of pelvic fragility fracture...
July 13, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28706175/-characteristics-and-risk-factors-for-falls-in-tertiary-hospital-inpatients
#18
Eun Ju Choi, Young Shin Lee, Eun Jung Yang, Ji Hui Kim, Yeon Hee Kim, Hyeoun Ae Park
PURPOSE: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. METHODS: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics...
June 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28706099/cross-sectional-study-of-the-hospital-management-of-adult-patients-with-a-suspected-seizure-epic2
#19
Jon Mark Dickson, Hannah Dudhill, Jane Shewan, Sue Mason, Richard A Grünewald, Markus Reuber
OBJECTIVE: To determine the clinical characteristics, management and outcomes of patients taken to hospital by emergency ambulance after a suspected seizure. DESIGN: Quantitative cross-sectional retrospective study of a consecutive series of patients. SETTING: An acute hospital trust in a large city in England. PARTICIPANTS: In 2012-2013, the regions' ambulance service managed 605 481 emergency incidents, 74 141/605 481 originated from Sheffield (a large city in the region), 2121/74 141 (2...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704008/-can-mobilization-preserve-the-elderly-hospitalized-from-functional-decline
#20
Marie Méan, Christophe Bula, Gérard Waeber
Up to 65% of older adults who walk independently will lose this capacity during a hospital stay. In older adults, loss of walking independence increases the length of hospital stay, the need for rehabilitation services and for institutionalization, as well as the risk of falls (during hospital stay and after discharge) and the risk of death. Bed rest or limited walking during a hospital stay causes deconditioning and is one of the primary risk factors for loss of independence and adverse outcome in hospitalized older adults...
January 25, 2017: Revue Médicale Suisse
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