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Limitations of studies with elderly

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https://www.readbyqxmd.com/read/29149153/analysis-of-reporting-bias-in-vertebral-augmentation
#1
Douglas P Beall, Sean M Tutton, Kieran Murphy, Wayne Olan, Christopher Warner, Jack B Test
Osteoporotic vertebral compression fractures (OVCFs) are a significant cause of morbidity and mortality in the United States and worldwide, with estimates of 750,000 to 1.5 million occurring annually. As the elderly population continues to increase, the incidence of OVCFs will continue to rise, as will the morbidity and mortality associated with this condition. Vertebral augmentation (VA) was almost universally accepted as the appropriate treatment modality prior to 2 sham trials published in 2009 by the New England Journal of Medicine (NEJM)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148534/genetic-testing-of-complement-and-coagulation-pathways-in-patients-with-severe-hypertension-and-renal-microangiopathy
#2
Christopher P Larsen, Jon D Wilson, Alejandro Best-Rocha, Marjorie L Beggs, Randolph A Hennigar
A diagnosis of thrombotic microangiopathy on kidney biopsy in a patient presenting with hypertensive emergency has historically elicited the diagnosis of malignant hypertension-associated thrombotic microangiopathy. Recent studies, however, have raised awareness that a number of these patients may actually represent atypical hemolytic uremic syndrome. To further investigate this premise, we performed next-generation sequencing to interrogate the coding regions of 29 complement and coagulation cascade genes associated with atypical hemolytic uremic syndrome in 100 non-elderly patients presenting with severe hypertension, renal failure and a kidney biopsy showing microangiopathic changes limited to the classic accelerated hypertension-associated lesion of arterial intimal edema ('mucoid intimal hyperplasia') in isolation and without accompanying glomerular microthrombi...
November 17, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/29147653/health-status-and-the-demand-for-healthcare-among-the-elderly-in-the-rural-quoc-oai-district-of-hanoi-in-vietnam
#3
Kyung-Sook Bang, Sunghee H Tak, Juhwan Oh, Jinseon Yi, Soo-Young Yu, Truong Quang Trung
Background: Vietnam is experiencing an unprecedented demographic transition. Its proportion of elderly people is growing rapidly. Objective: This study explored the health status and health-related quality of life (HRQoL) of rural elderly Vietnamese and assessed their needs for healthcare services. Design: This study used a survey with stratified proportion sampling and quota assignment. In 2016, data was collected from 713 people in the rural Quoc-Oai district of Hanoi aged 60 or older...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29145824/observations-on-significant-hemodynamic-changes-caused-by-a-high-concentration-of-epidurally-administered-ropivacaine-correlation-and-prediction-study-of-stroke-volume-variation-and-central-venous-pressure-in-thoracic-epidural-anesthesia
#4
Jeong-Min Hong, Hyeon Jeong Lee, Young-Jae Oh, Ah Rhem Cho, Hyae Jin Kim, Do-Won Lee, Wang-Seok Do, Jae-Young Kwon, Haekyu Kim
BACKGROUND: Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia. METHODS: A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0...
November 16, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29144542/autoimmune-diseases-and-breast-cancer-risk-by-tumor-hormone-receptor-status-among-elderly-women
#5
Catherine Schairer, Ruth M Pfeiffer, Shahinaz M Gadalla
The female preponderance of many autoimmune diseases suggests a possible hormonal etiology. Little research exists on systemic and organ-specific autoimmune diseases and risk of breast cancer by tumor estrogen receptor (ER)- and progesterone receptor (PR)- status. Here we evaluate associations between selected systemic and organ-specific autoimmune diseases and breast cancer risk overall and by tumor ER- and PR-status. We used linked Surveillance, Epidemiology and End Results (SEER)-Medicare data, with first female breast cancer cases ages ≥66 years identified by SEER registries (years 1992-2011) (N = 209,929)...
November 16, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29138992/use-of-ketamine-in-elderly-patients-with-treatment-resistant-depression
#6
REVIEW
Carolina Medeiros da Frota Ribeiro, Patricio Riva-Posse
PURPOSE OF REVIEW: The purpose of this paper is to provide a review of the use of ketamine as an antidepressant for treatment-resistant depression (TRD) in the geriatric population. Available treatment options for late-life treatment-resistant depression are limited and include electroconvulsive therapy and transcranial magnetic stimulation as well as possible pharmacologic augmentation. Ketamine has been shown to be a promising treatment in TRD; however, data regarding the use of ketamine in the elderly includes only five case reports...
November 15, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29137700/limitation-of-therapeutic-effort-in-patients-hospitalised-in-departments-of-internal-medicine
#7
R García Caballero, B Herreros, D Real de Asúa, S Gámez, G Vega, L García Olmos
INTRODUCTION: There is little information on the limitation of therapeutic effort (LTE) in patients admitted to hospital internal medicine units. OBJECTIVES: To describe the indicated LTE regimens in the departments of internal medicine and the characteristics of the patients who undergo them. PATIENTS AND METHODS: An observational, descriptive retrospective study was conducted on 4 hospitals of the Community of Madrid. The study collected demographic and comorbidity data and the LTE orders prescribed for all patients who died during a period of 6 months...
November 11, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29132940/bullseye-s-representation-of-cerebral-white-matter-hyperintensities
#8
Carole H Sudre, Beatriz Gomez Anson, Indran Davagnanamd, Anne Schmitt, Alex F Mendelson, Ferran Prados, Lorna Smith, David Atkinson, Alun David Hughes, Nish Chaturvedi, M Jorge Cardoso, Frederik Barkhof, Hans Rolf Jaeger, Sébastien Ourselin
BACKGROUND AND PURPOSE: Visual rating scales have limited capacities to depict the regional distribution of cerebral white matter hyperintensities (WMH). We present a regional-zonal volumetric analysis alongside a visualization tool to compare and deconstruct visual rating scales. MATERIALS AND METHODS: 3D T1-weighted, T2-weighted spin-echo and FLAIR images were acquired on a 3T system, from 82 elderly participants in a population-based study. Images were automatically segmented for WMH...
November 10, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29132305/associations-between-skin-barrier-characteristics-skin-conditions-and-health-of-aged-nursing-home-residents-a-multi-center-prevalence-and-correlational-study
#9
Elisabeth Hahnel, Ulrike Blume-Peytavi, Carina Trojahn, Jan Kottner
BACKGROUND: Geriatric patients are affected by a range of skin conditions and dermatological diseases, functional limitations and chronic diseases. Skin problems are highly prevalent in elderly populations. Aim of this study was to investigate possible associations between health, functional and cutaneous variables in aged long-term care residents. METHODS: This observational, cross-sectional, descriptive prevalence study was conducted in a random sample of 10 institutional long-term care facilities in Berlin...
November 13, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29132188/-hearing-loss-and-speech-recognition-in-the-elderly
#10
Petra von Gablenz, Inga Holube
Elderly people often complain about poor speech understanding in noisy environments. In clinical practice, speech tests under noise conditions are used to examine hearing ability. The HÖRSTAT study, conducted on a population-based random sample consisting of 1903 adults, used the Goettingen Sentence Test (GÖSA) under noise conditions along with pure-tone audiometry. Hearing impairment was defined as pure-tone average at 0.5, 1, 2 and 4 kHz (PTA-4) greater than 25 dB HL in the better ear (WHO criterion). As expected, pure-tone thresholds and speech recognition thresholds (SRT) in GÖSA worsened steadily with age...
November 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29130441/is-the-device-oriented-subjective-outcome-doso-independent-of-personality
#11
Yu-Hsiang Wu, Kelsey Dumanch, Elizabeth Stangl, Christi Miller, Kelly Tremblay, Ruth Bentler
BACKGROUND: Self-report questionnaires are a frequently used method of evaluating hearing aid outcomes. Studies have shown that personality can account for 5-20% of the variance in response to self-report measures. As a result, these influences can impact results and limit their generalizability when the purpose of the study is to examine the technological merit of hearing aids. To reduce personality influences on self-report outcome data, the Device-Oriented Subjective Outcome (DOSO) was developed...
November 2017: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/29126046/study-on-the-foot-shape-characteristics-of-the-elderly-in-china
#12
Xiang Dong Luo, Chao-Hua Xue, Yan Li
BACKGROUND: With aging, the feet of the elderly above 60 years old in China present degenerative changes, deformities, and diseases, which significantly affect their daily activities. OBJECTIVES: The authors aimed to study the morphological characteristics of the feet and identify the foot type according to size (length and width) and defect characteristics of elderly feet in China. METHODS: A convenient sample of 1000 subjects above 60 years old was recruited mainly in the regions of Shanghai, Shaanxi, Henan, Hebei, and Sichuan in China...
April 24, 2017: Foot
https://www.readbyqxmd.com/read/29125120/canal-to-diaphysis-ratio-as-a-risk-factor-for-hip-fractures-and-hip-fracture-pattern
#13
Prasad Ellanti, Kunal Mohan, Andrew Moriarity, Niall Hogan, Tom McCarthy
INTRODUCTION: Osteoporosis and related fractures constitute a significant burden on modern healthcare. The standard method of diagnosing osteoporosis with a dual-energy X-ray absorptiometry (DXA) scan is limited by accessibility and expense. The thickness of the cortex of the proximal femur on plain radiographs has been suggested to be a method for indicating osteoporosis and as a risk factor of hip fractures in the elderly. METHODS: A retrospective study was undertaken to assess the usefulness of the canal-diaphysis ratio (CDR) as a risk factor for developing a hip fracture, excluding patients presenting under 50 years old, following high-energy trauma or pathological fractures...
2017: SICOT-J
https://www.readbyqxmd.com/read/29121850/the-challenge-of-involving-elderly-patients-in-primary-care-by-using-an-electronic-communication-tool-with-their-professionals-a-mixed-methods-study
#14
Catharina Carolina De Jong, Wynand J G Ros, Mia Van Leeuwen, Guus Schrijvers
BACKGROUND: Elderly patients in primary care often have multiple health problems,with different healthcare professionals involved. For consistency in care, it is required that communication amongst professionals and patient-systems (patient and informal-carers) be well tuned. Electronic-communication can make it easier for patient-system to be active in care. OBJECTIVE: To examine whether an e-communication tool (Congredi) designed for professionals, including a care plan and secure e-mail, is usable for patient-systems and what their experiences are...
November 8, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29121413/person-centredness-in-elder-care-a-secondary-analysis-of-data-from-a-study-among-home-dwelling-men-and-women-in-the-faroe-islands
#15
Ása Róin
AIMS AND OBJECTIVES: As individuals in Western societies age, there is increasing demand for home-based care to help older people stay in their homes for as long as possible and provide services that ensure a person's quality of life in old age. Numerous attempts are made to develop a framework to secure quality of care. However, research has shown insufficient quality in care for older people. In this paper, the purpose is to study how older people's experiences with home care reflect a person-centred approach to care...
November 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29119468/clinical-decision-support-and-optional-point-of-care-testing-of-renal-function-for-safe-use-of-antibiotics-in-elderly-patients-a-retrospective-study-in-community-pharmacy-practice
#16
Mette Heringa, Annemieke Floor-Schreudering, Peter A G M De Smet, Marcel L Bouvy
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over...
November 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29117244/re-establishing-safer-medical-circumcision-integrated-initiation-ceremonies-for-hiv-prevention-in-a-rural-setting-in-papua-new-guinea-a-multi-method-acceptability-study
#17
Clement Morris Manineng, David MacLaren, Maggie Baigry, Emil Trowalle, Reinhold Muller, Andrew Vallely, Patrick Gesch, Francis Hombhanje, William John McBride
BACKGROUND: Efforts to stem the spread of Human Immunodeficiency Virus (HIV) in Papua New Guinea (PNG) are hampered by multiple interrelated factors including limited health services, extreme diversities in culture and language and highly prevalent gender inequity, domestic violence and poverty. In the rural district of Yangoru-Saussia, a revival of previously ceased male initiation ceremonies (MICs) is being considered for a comprehensive approach to HIV prevention. In this study, we explore the local acceptability of this undertaking including replacing traditional penile cutting practices with medical male circumcision (MMC)...
2017: PloS One
https://www.readbyqxmd.com/read/29116285/speech-language-therapy-to-elderly-patients-in-a-health-care-network-in-florian%C3%A3-polis-a-health-surveillance-initiative
#18
Gabriela Maciel Mafra, Karina Mary de Paiva Vianna
PURPOSE: To investigate aspects of health care provided to the elderly, as a way to undertake health surveillance initiatives. METHODS: Cross-sectional quantitative study with elderly people who participate in health promotion groups in health centers at Florianópolis, Santa Catarina, Brazil. Surveys were conducted on aspects relative to comprehensive health care provision, namely, records of the Family Health Strategy, diagnosis, awareness of initiatives to treat non-communicable diseases, as well as awareness of related risks and complications...
November 6, 2017: CoDAS
https://www.readbyqxmd.com/read/29113899/neurosurgery-in-octogenarians-a-prospective-study-on-perioperative-morbidity-mortality-and-complications-in-elderly-patients
#19
Nicolai Maldaner, Johannes Sarnthein, Oliver Bozinov, Luca Regli, Marian Christoph Neidert
OBJECTIVE: The aging population in industrialized countries shifts the age limit for neurosurgical interventions towards increasingly older patients. This study investigates whether octogenarians (≥80 years) stand out in outcome and incidence of perioperative complications. METHODS: Consecutive patients ≥80 years operated between January 2013 to August 2016 were compared against a control group of patients aged 55 - 75 years matched by indication for surgery...
November 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29108382/clinicopathologic-features-and-prognostic-factors-for-patients-with-colorectal-cancer-who-are-75-years-and-older
#20
Mingfang Zhao, Hans Liu, Yanqing Tang, Xin Meng, Jun Yu, Qi Wang, Qiao Zhou, Sean X Leng, Haiyan Zhang
Colorectal cancer (CRC) is common and can be considered as a disease of older adults. About one half of the cases were diagnosed in patients over 70 years of age. Decision-making about treatment for these older patients can be complicated by age-related physiological changes, impaired functional status, limited social support, and comorbidities. Many trials excluded patients using an upper limit of 75 years of age. Little is known about prognostic factors in patients who are over this age limit. In this study, we conducted an analysis in the Surveillance, Epidemiology and End Results (SEER) database to identify specific clinicopathologic features and prognostic factors for these vulnerable cancer patients (N= 293,616)...
October 3, 2017: Oncotarget
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