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Limitations of studies with elderly

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https://www.readbyqxmd.com/read/28429988/patient-safety-in-nursing-homes-in-sweden-nurses-views-on-safety-and-their-role
#1
Frieda Andersson, Katarina Hjelm
Objective Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#2
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28422889/an-in-vitro-biomechanical-evaluation-of-an-expansive-double-threaded-bi-directional-compression-screw-for-fixation-of-type-ii-odontoid-process-fractures-a-squire-compliant-article
#3
Ning Liu, Li Tian, Rong-Xian Jiang, Chao Xu, Lei Shi, Wei Lei, Yang Zhang
Odontoid process fracture accounts for 5% to 15% of all cervical spine injuries, and the rate is higher among elderly people. The anterior cannulated screw fixation has been widely used in odontoid process fracture, but the fixation strength may still be limited under some circumstances. This study aims to investigate the biomechanical fixation strength of expansive double-threaded bi-directional compression screw (EDBCS) compared with cannulated lag screw (CLS) and improved Herbert screw (IHS) for fixation of type II odontoid process fracture...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421909/management-of-intra-abdominally-translocated-contraceptive-devices-is-surgery-the-only-way-to-treat-this-problem
#4
Mustafa Gazi Uçar, Fatih Şanlıkan, Tolgay Tuyan Ilhan, Ahmet Göçmen, Çetin Çelik
This study was a multi-centre retrospective review of patients with uterine perforation caused by intrauterine contraceptive devices (IUDs). A total of 15 patients were registered, in a seven year period. Among them, five were asymptomatic and the rest were symptomatic. Asymptomatic patients were managed conservatively, except in one case in which the patient requested surgery because she also wanted a tubal ligation. Symptomatic patients all underwent surgery. All the surgeries were elective and all the surgical procedures were initiated laparoscopically...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28420324/evaluation-of-a-technology-enhanced-integrated-care-model-for-frail-older-persons-protocol-of-the-spec-study-a-stepped-wedge-cluster-randomized-trial-in-nursing-homes
#5
Hongsoo Kim, Yeon-Hwan Park, Young-Il Jung, Hyoungshim Choi, Seyune Lee, Gi-Soo Kim, Dong-Wook Yang, Myunghee Cho Paik, Tae-Jin Lee
BACKGROUND: Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. METHODS/DESIGN: SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate...
April 18, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28418066/a-national-survey-on-the-effect-of-the-geriatric-academic-career-award-in-advancing-academic-geriatric-medicine
#6
Kevin T Foley, Clare C Luz, Katherine V Hanson, Yuning Hao, Elisia M Ray
A workforce that understands principles of geriatric medicine is critical to addressing the care needs of the growing elderly population. This will be impossible without a substantial increase in academicians engaged in education and aging research. Limited support of early-career clinician-educators is a major barrier to attaining this goal. The Geriatric Academic Career Award (GACA) was a vital resource that benefitted 222 junior faculty members. GACA availability was interrupted in 2006, followed by permanent discontinuation after the Geriatrics Workforce Education Program (GWEP) subsumed it in 2015, leaving aspiring clinician-educators with no similar alternatives...
April 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28416829/-clinical-characteristics-and-prognosis-of-cultured-negative-pyogenic-spondylitis
#7
Y P Cui, C Mi, X D Shi, B Wang, Y X Pan, Y F Lin
OBJECTIVE: There are limited data describing the clinical characteristics and prognosis of culture negative pyogenic spondylitis. The aim of this study was to investigate the treatment, prognosis and clinical characteristics of culture negative pyogenic spondylitis. METHODS: A retrospective study reviewed 74 patients who were diagnosed with spondylitis in Peking University First Hospital from January 2010 to December 2015. A total of 27 patients suffered from pyogenic spondylitis...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416124/assessment-of-the-external-validity-of-the-national-comprehensive-cancer-network-and-european-society-for-medical-oncology-guidelines-for-non-small-cell-lung-cancer-in-a-population-of-patients-aged-80-years-and-older
#8
REVIEW
Nicolò Matteo Luca Battisti, Marina Sehovic, Martine Extermann
Non-small-cell lung cancer (NSCLC) is a disease of the elderly, who are under-represented in clinical trials. This challenges the external validity of the evidence base for its management and of current guidelines, that we evaluated in a population of older patients. We retrieved randomized clinical trials (RCTs) supporting the guidelines and identified 18 relevant topics. We matched a cohort of NSCLC patients aged older than 80 years from the Moffitt Cancer Center database with the studies' eligibility criteria to check their qualification for at least 2 studies...
March 21, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28415627/importance-of-the-plasma-soluble-hla-g-levels-for-prognostic-stratification-with-traditional-prognosticators-in-colorectal-cancer
#9
Jing-Bo Li, Yan-Yun Ruan, Bin Hu, Shan-Shan Dong, Tie-Nan Bi, Aifen Lin, Wei-Hua Yan
An increased peripheral soluble HLA-G (sHLA-G) expression has been observed in various malignancies while its prognostic significance was rather limited. In this study, the prognostic value of plasma sHLA-G in 178 colorectal cancer (CRC) patients was investigated. sHLA-G levels were analyzed by specific enzyme-linked immunosorbent assay. Data showed sHLA-G levels were significantly increased in CRC patients compared with normal controls (36.8 U/ml vs 25.4 U/ml, p = 0.009). sHLA-G in the died were obviously higher than that of alive CRC patients (46...
March 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28410285/comorbidities-in-patients-with-chronic-obstructive-pulmonary-disease-and-pulmonary-rehabilitation-outcomes
#10
Pichapong Tunsupon, Ashima Lal, Mohammed Abo Khamis, M Jeffery Mador
PURPOSE: The objective of this study was to evaluate the impact of comorbidities as potential predictors of the response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). METHODS: The study included 165 patients with COPD with exercise limitations. Comorbidity was classified as cardiac, metabolic, orthopedic, behavioral health problems, or other diseases. Number of comorbidities was grouped as 0, 1, or ≥2. Outcomes were defined as improvement in exercise capacity (maximal exercise capacity, 6-minute walk test, and constant workload cycle exercise duration) and quality of life (Chronic Respiratory Questionnaire)...
April 12, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28408716/sex-specific-comparative-effectiveness-of-oral-anticoagulants-in-elderly-patients-with-newly-diagnosed-atrial-fibrillation
#11
Ghanshyam Palamaner Subash Shantha, Prashant D Bhave, Saket Girotra, Denice Hodgson-Zingman, Alexander Mazur, Michael Giudici, Elizabeth Chrischilles, Mary S Vaughan Sarrazin
BACKGROUND: Sex-specific comparative effectiveness of direct oral anticoagulants among patients with nonvalvular atrial fibrillation is not known. Via this retrospective cohort study, we assessed the sex-specific, comparative effectiveness of direct oral anticoagulants (rivaroxaban and dabigatran), compared to each other and to warfarin among patients with atrial fibrillation. METHODS AND RESULTS: Elderly (aged ≥66 years) Medicare beneficiaries enrolled in Medicare Part D benefit plan from November 2011 to October 2013 with newly diagnosed atrial fibrillation formed the study cohort (65 734 [44...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28406421/advantages-and-disadvantages-of-using-the-prisma7-to-determine-the-elderly-subjects-for-whom-the-smaf-is-useful-for-assessing-functional-status-in-bobo-dioulasso-burkina-faso
#12
A Berthé, M A S Somda, L Berthé-Sanou, B Konaté, H Hien, E Bayala, F Tou, M Drabo, F Badini-Kinda, J Macq
One of the difficulties faced by African actors working with the elderly is the lack of appropriate tools for the identification and/or diagnosis of functional disabilities among older people in this limited-resource (material, human, and financial) setting. This study sought to assess the advantages and disadvantages of the combined use of two tools, PRISMA7 (for identifying older individuals at risk of functional disabilities and loss of autonomy) and SMAF (to evaluate the functional status of the elderly) in Bobo-Dioulasso (Burkina Faso)...
February 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28404609/moxibustion-versus-diclofenac-sodium-gel-for-the-treatment-of-knee-osteoarthritis-a-study-protocol-for-a-double-blinded-double-placebo-randomised-controlled-trial
#13
Jian-Ying Zhou, Ling Luo, Lin-Lin Zhu, Hai-Yan Yin, Qiaofeng Wu, Jia-Xi Peng, Cheng-Shun Zhang, Peng Lv, Yong Tang, Shu-Guang Yu
INTRODUCTION: Knee osteoarthritis is a common form of arthritis in elderly patients that is characterised by pain and functional limitation. Moxibustion has been employed to relieve chronic pain as an alternative therapy for knee osteoarthritis. However, the evidence of its efficacy is equivocal due to the low methodological quality in most clinical studies. Therefore, we are performing a double-blinded, double-placebo, randomised controlled trial to evaluate the efficacy of moxibustion in participants with knee osteoarthritis...
April 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28403822/provider-and-patient-perspectives-on-opioids-and-alternative-treatments-for-managing-chronic-pain-a-qualitative-study
#14
Lauren S Penney, Cheryl Ritenbaugh, Lynn L DeBar, Charles Elder, Richard A Deyo
BACKGROUND: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. METHODS: Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14)...
March 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28399722/safety-and-function-of-a-prototype-microprocessor-controlled-knee-prosthesis-for-low-active-transfemoral-amputees-switching-from-a-mechanic-knee-prosthesis-a-pilot-study
#15
Timothy Hasenoehrl, Thomas Schmalz, Reinhard Windhager, Stephan Domayer, Sara Dana, Clemens Ambrozy, Stefano Palma, Richard Crevenna
PURPOSE: Aim of this pilot study was to assess safety and functioning of a microprocessor-controlled knee prosthesis (MPK) after a short familiarization time and no structured physical therapy. MATERIALS AND METHODS: Five elderly, low-active transfemoral amputees who were fitted with a standard non-microprocessor controlled knee prosthesis (NMPK) performed a baseline measurement consisting of a 3 D gait analysis, functional tests and questionnaires. The first follow-up consisted of the same test procedure and was performed with the MPK after 4 to 6 weeks of familiarization...
April 11, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28398133/combined-effect-of-obesity-and-mobility-limitation-with-incident-of-type-2-diabetes-and-mortality-in-chinese-elderly
#16
Li Kang, Liye Jia, Peipei Han, Wen Zhang, Yixuan Ma, Liyuan Fu, Hairui Yu, Xiaoyu Chen, Lu Wang, Lin Hou, Xing Yu, Jianing Song, Ruiming He, Hui Li, Tingting Miao, Xiaolong Yang, Kaijun Niu, Liancheng Wang, Qi Guo
OBJECTIVE: This article aims to examine the effect of mobility limitation and obesity on the risk of new incidence of type 2 diabetes mellitus and mortality . METHODS: The design was a cohort study (n=1075) among adults aged 60 years and older. Obesity was defined as body mass index greater than or equal to 28 kg/m2. Mobility limitation was defined as participants scoring in the top 20% on the Timed Up and Go Test (TUGT) or in the slowest 20% for the 4-m walking test...
April 11, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28396010/analysis-of-the-variability-of-the-pharmacokinetics-of-multiple-drugs-in-young-adult-and-elderly-subjects-and-its-implications-for-acceptable-daily-exposures-and-cleaning-validation-limits
#17
REVIEW
Anthony J Streeter, Ellen C Faria
The elderly constitute a significant, potentially sensitive, subpopulation within the general population, which must be taken into account when performing risk assessments including determining an acceptable daily exposure (ADE) for the purpose of a cleaning validation. Known differences in the pharmacokinetics of drugs between young adults (who are typically the subjects recruited into clinical trials) and the elderly are potential contributors affecting the interindividual uncertainty factor (UFH) component of the ADE calculation...
March 20, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28392692/antifungal-optical-and-mechanical-properties-of-polymethylmethacrylate-material-incorporated-with-silanized-zinc-oxide-nanoparticles
#18
Krid Kamonkhantikul, Mansuang Arksornnukit, Hidekazu Takahashi
BACKGROUND: Fungal infected denture, which is typically composed of polymethylmethacrylate (PMMA), is a common problem for a denture wearer, especially an elderly patient with limited manual dexterity. Therefore, increasing the antifungal effect of denture by incorporating surface modification nanoparticles into the PMMA, while retaining its mechanical properties, is of interest. AIM OF THE STUDY: This study aimed to evaluate antifungal, optical, and mechanical properties of heat-cured PMMA incorporated with different amounts of zinc oxide nanoparticles (ZnOnps) with or without methacryloxypropyltrimethoxysilane modification...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28392190/prevalence-patterns-and-predictors-of-depression-treatment-among-community-dwelling-elderly-individuals-with-dementia-in-the-united-states
#19
Sandipan Bhattacharjee, Yeum Mok Oh, Eric M Reiman, William J Burke
OBJECTIVES: Co-occurring dementia and depression exerts a substantial burden on the elderly. This study utilizes data from a nationally representative cohort of community-dwelling individuals 65 years and older to examine the prevalence, patterns, and predictors of depression treatment among elderly individuals with co-occurring dementia and depression. DESIGN: Retrospective, cross-sectional study. SETTING: Multiple years of Medical Expenditure Panel Survey (2002, 2004, 2006, 2008, 2010, and 2012) data...
March 6, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28392076/postmarketing-surveillance-studies-an-industry-perspective-on-changing-global-requirements-and-implications
#20
REVIEW
Arshadul Haque, Sajjan Daniel, Tricia Maxwell, Mariette Boerstoel
PURPOSE: This article describes postmarketing surveillance (PMS) study regulations and expectations of the regulatory agencies in 5 countries. With a focus on postapproval drug safety, there is a continuous need for understanding the benefit-risk profile of an approved drug. In addition to spontaneous adverse-event reporting, regulatory agencies seem to be more reliant on PMS studies. The opportunity to systematically monitor use in special populations, such as elderly patients and those with comorbid conditions, also presents itself during postmarketing use...
April 6, 2017: Clinical Therapeutics
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