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Limitations of studies with elderly

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https://www.readbyqxmd.com/read/29785289/what-is-the-role-of-wedge-resection-for-t1a-lung-cancer
#1
Sebron Harrison, Brendon Stiles, Nasser Altorki
Since 1995, lobar resection became the standard of care for medically fit patients with early stage lung cancer. This was based on the results of a single randomized trial comparing lobectomy and sublobar resection (SLR) in stage I lung cancer conducted by the lung cancer study group between 1982 and 1988. The conclusions of the study included a statistically significant tripling in loco-regional recurrence (LR) after limited resection but no difference between the two arms of the trial in systemic recurrence...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29780856/the-role-of-meaning-in-life-for-the-quality-of-life-of-community-dwelling-chinese-elders-with-low-socioeconomic-status
#2
Raymond Chi-Fai Chui
Objectives: There is limited research on the meaning in life among Chinese elders. This study aims to examine the association among functional disabilities, meaning in life, social network, and quality of life in community-dwelling Chinese elders with low socioeconomic status. Methods: A cross-sectional survey was used to collect data from 339 poor community-dwelling Chinese elders aged 60 and above. Results: The results showed that meaning in life and social network were significantly related to quality of life...
January 2018: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29779794/understanding-pain-and-pain-management-in-elderly-nursing-home-patients-applying-an-interprofessional-learning-activity-in-health-care-students-a-norwegian-pilot-study
#3
Elin Damsgård, Hege Solgård, Karin Johannessen, Katrine Wennevold, Gunnvald Kvarstein, Gunn Pettersen, Beate Garcia
Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans...
May 17, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29776316/a-systematic-review-and-combined-analysis-of-therapeutic-drug-monitoring-studies-for-oral-paliperidone
#4
Georgios Schoretsanitis, Edoardo Spina, Christoph Hiemke, Jose de Leon
This article includes a combined analysis of therapeutic drug monitoring (TDM) studies and a review of the marketer's data on pharmacological mechanisms. Areas covered: An article search led to the inclusion of 21 paliperidone studies in the systematic review plus 2 case reports. Paliperidone clearance was calculated from: 1) steady-state studies using concentration/dose (C/D) ratios, and 2) single-dose studies describing 24-hour area under the curve calculations. The marketed extended-release formulation has 28% bioavailability...
May 18, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29770802/assessing-social-quality-of-sheltered-independent-housing-challenges-of-scale-and-group-mix
#5
T G M Spierings, P M Ache
Forecasts for many cities and regions in Europe predict a growing share of 'elderly' people in the overall population. In addition to this general ageing process, the number of very old people is of specific importance for the issue under discussion. This article looks at sheltered independent housing and living. In particular, the article presents the results of a quantitative and qualitative multidisciplinary study of those facilities in the Netherlands. The research provides insight into the effect of physical scale and group mix on the social quality of sheltered independent housing...
2018: Journal of housing and the built environment: HBE
https://www.readbyqxmd.com/read/29767793/inhalation-of-house-dust-and-ozone-alters-systemic-levels-of-endothelial-progenitor-cells-oxidative-stress-and-inflammation-in-elderly-subjects
#6
Kim Jantzen, Annie Jensen, Ali Kermanizadeh, Grethe Elholm, Torben Sigsgaard, Peter Møller, Martin Roursgaard, Steffen Loft
Ambient air pollution including ozone and especially particulate matter represents important causes of cardiovascular disease. However, there is limited knowledge on indoor air dust with respect to this risk and the potential interactions between dust and ozone. Here, we exposed 23 healthy elderly subjects for 5.5 h, to either clean air, house dust at 275 µg/m3 (diameter < 2.5 µm), ozone at 100 ppb or combined house dust and ozone in a double-blinded randomized cross-over study. The combined house dust and ozone exposure was associated with a 48% (95% CI 24%-65%) decrease as compared with the clean air exposure, in CD34+KDR+ late endothelial progenitor cells (EPCs) per leukocyte in the blood shortly after exposure, whereas none of the single exposures resulted in a significant effect...
May 14, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29765105/neural-predisposing-factors-of-postoperative-delirium-in-elderly-patients-with-femoral-neck-fracture
#7
Sunghyon Kyeong, Jung Eun Shin, Kyu Hyun Yang, Woo Suk Lee, Tae-Sub Chung, Jae-Jin Kim
Elderly adults are more likely to develop delirium after major surgery, but there is limited knowledge of the vulnerability for postoperative delirium. In this study, we aimed to identify neural predisposing factors for postoperative delirium and develop a prediction model for estimating an individual's probability of postoperative delirium. Among 57 elderly participants with femoral neck fracture, 25 patients developed postoperative delirium and 32 patients did not. We preoperatively obtained data for clinical assessments, anatomical MRI, and resting-state functional MRI...
May 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29763884/joint-angle-and-movement-velocity-effects-on-muscle-activity-of-elderly-with-knee-osteoarthritis-categorized-and-probabilistic-analysis
#8
João Pedro Batista, Ligia Maria Facci, Alexandre Roberto Marcondes Pelegrinelli, Sylvie Charlotte Frieda Anneliese von Werder, Daniella Carneiro de Souza, Marcelo Taglietti, Josilainne Marcelino Dias, Catherine Disselhorst-Klug, Jefferson Rosa Cardoso
The aim of the study was to determine the effects of joint angle position and angular velocity on concentric and eccentric knee muscles activity of elderly with osteoarthritis (OA) in a deterministic and probabilistic approach compared to matched controls. Concentric and eccentric muscle activation of vastus medialis (VM) and semitendinous (ST) muscles were recorded of eleven elderly women with knee OA (median (Md (25-75%)) age of 62 years (60-72) and Md of body mass index (BMI) of 26 kg/m2 (24.5-27.2)) and ten controls (Md 65 years (62-69) and Md of BMI 24...
April 27, 2018: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/29762462/the-safety-and-utility-of-fiberoptic-bronchoscopy-in-the-very-elderly
#9
Cameron W McLaughlin, Andrew J Skabelund, Ellis R Easterling, Michael J Morris
BACKGROUND: Flexible bronchoscopy (FB) is a common modality for diagnostic sampling within the thorax. It is utilized often in the elderly population, but there is limited data on the safety and utility of the procedure in the very elderly. METHODS: FBs performed outside the intensive care unit in the San Antonio Military Health System on patients 85 years and older were reviewed. Outcomes including indications, complications, diagnostic yield, and final diagnosis were compared with a control group consisting of patients' ages of 65 to 79 years old...
May 14, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29762312/the-influence-of-occupation-on-wellbeing-as-experienced-by-the-elderly-a-systematic-review
#10
Christina Jessen-Winge, Mille Nyboe Petersen, Anne-Le Morville
OBJECTIVE: The objective of this review was to synthesize knowledge regarding which types of occupations the elderly perceive as important to and supporting their overall wellbeing. INTRODUCTION: Being active is an important part of managing the daily challenges of advanced old age. Occupational therapy and occupational science are based on the premise that a person's occupations are intertwined with their health and are thus needed for them to experience a meaningful life and improve their wellbeing...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29760598/predictors-of-chemoradiation-related-febrile-neutropenia-prophylaxis-in-older-adults-experience-from-a-limited-resource-setting
#11
Aparna Gangopadhyay
Aim: To identify risk factors that lower efficacy of antibiotic prophylaxis of febrile neutropenia among older patients on chemoradiation. Background: Audit of institutional data showed that older adults are at higher risk of febrile neutropenia during chemoradiation. In limited resource settings widespread use of Granulocyte-Colony Stimulating Factor (G-CSF) is not economically feasible and antibiotics are used commonly. Despite compliance with antibiotics, prophylaxis is inadequate in many patients owing to patient and tumor related factors...
May 2018: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/29759801/-evaluation-of-the-prescription-of-furosemide-in-persons-aged-75years-and-older-in-a-geriatric-acute-care-unit
#12
M Buttard, A Putot, P d'Athis, L Pioro, S Asgassou, S Putot, M Deïdda, C Laborde, M Dipanda, R Mahmoudi, P Manckoundia
INTRODUCTION: Furosemide is very often prescribed in France. It may cause important adverse effects especially in elderly persons. In order to limit its misuse and excessive expenditure for health insurance organizations, the European Society of Cardiology drafted strict guidelines for its prescription. We conducted a study in this population to determine the rate of prescription of furosemide in elderly persons outside the guidelines. METHOD: This was a prospective, single-centre, observational study bearing on elderly persons aged 75years and more admitted to a geriatric acute-care unit over a period of 6months...
May 11, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29759150/comprehensive-characterization-of-circulating-and-bone-marrow-derived-multiple-myeloma-cells-at-minimal-residual-disease
#13
REVIEW
Johannes M Waldschmidt, Praveen Anand, Birgit Knoechel, Jens G Lohr
The presence or absence of minimal residual disease (MRD) in patients with multiple myeloma (MM) has emerged as a useful marker to determine the depth of remission. MRD negativity as an endpoint has been shown to be associated with improved progression-free survival in many studies. MRD detection is therefore part of numerous clinical trial protocols for MM. At the present time, two methodologies are most widely accepted for MRD detection: (1) multicolor flow cytometry and (2) next-generation sequencing-based clonotype detection...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29757960/comparison-of-factors-associated-with-fear-of-falling-between-older-adults-with-and-without-a-fall-history
#14
Seonhye Lee, Eunmi Oh, Gwi-Ryung Son Hong
Background : Although fear of falling (FOF) has been studied since FOF has negative consequences for the elderly, there is limited information about the risk factors of FOF, including the environment. The purpose of this study was to describe individual and environmental factors of FOF between those with and without a fall history from an ecological aspect and to examine whether individual and environmental factors differently affect the FOF according to the state of fall history in community-dwelling older adults in Korea...
May 14, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29756989/under-diagnosis-and-over-diagnosis-of-asthma
#15
Shawn D Aaron, Louis Philippe Boulet, Helen K Reddel, Andrea Gershon
Asthma is diagnosed based on patients' respiratory symptoms of wheeze, cough, chest tightness and/or dyspnea together with physiologic evidence of variable and reversible expiratory airflow limitation. In the United States 7.6% of adults and 8.4% of children self-report a physician diagnosis of current asthma. Population-based studies in children, adults and the elderly suggest that from 20% to 70% of asthmatics in the community remain undiagnosed and hence untreated. Under-diagnosis of asthma has been found to be associated with under-reporting of respiratory symptoms by patients to their physicians as well as poor socio-economic status...
May 14, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29755655/dose-finding-study-of-intensive-weekly-alternating-schedule-of-docetaxel-5-fluorouracil-and-oxaliplatin-fd-fox-regimen-in-metastatic-gastric-cancer
#16
Gemma Bruera, Silvia Massacese, Antonio Galvano, Antonella Dal Mas, Stefano Guadagni, Giuseppe Calvisi, Eugenio Ciacco, Antonio Russo, Enrico Ricevuto
Introduction: Proper administration timing, dose-intensity, efficacy/toxicity ratio of triplet docetaxel (DTX), 5-fluorouracil (5-FU), and oxaliplatin (OXP) should be improved to safely perform three-drugs intensive first line in advanced gastric cancer (GC). This dose-finding study investigated recommended 5-FU and OXP doses, safety of triplet regimen and preliminary activity. Methods: Schedule: 12h-timed-flat-infusion 5-FU 700-1000 mg/m2 /d 1-2, 8-9, 15-16, 22-23, with 100 mg/m2 /d increase for dose level; DTX 50 mg/m2 d 1, 15 fixed dose, OXP at three increasing dose-levels 60-70-80 mg/m2 d 8, 22, every 4 weeks...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29753158/melphalan-based-reduced-intensity-conditioning-is-associated-with-favorable-disease-control-and-acceptable-toxicities-in-patients-older-than-70-with-hematologic-malignancies-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#17
Monzr M Al Malki, Nitya Nathwani, Dongyun Yang, Saro Armenian, Sanjeet Dadwal, Jaroslava Salman, Sally Mokhtari, Thai Cao, Karamjeet Sandhu, Michelle Rouse, Matthew Mei, Haris Ali, Pablo Parker, Joseph Alvarnas, Eileen Smith, Margaret O Donnell, Guido Marcucci, David Snyder, Auayporn Nademanee, Stephen J Forman, Anthony Stein, Ryotaro Nakamura
Allogeneic hematopoietic stem cell transplantation (AlloHCT) is offered increasingly to elderly patients with hematologic malignancies. However, outcome data in those who are 70 years or older are limited, and no standard conditioning regimen has been established for this population. In this retrospective study, we evaluated the outcome of 53 consecutive patients aged 70 years and older who underwent AlloHCT with melphalan (Mel)-based reduced-intensity conditioning (RIC) at City of Hope. Engraftment was prompt, with median time to neutrophil engraftment of 15 days...
May 9, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29745795/diastolic-stress-testing-similarities-and-differences-between-isometric-handgrip-and-cycle-echocardiography
#18
Thomas Jake Samuel, Rhys Beaudry, Mark J Haykowsky, Satyam Sarma, Michael D Nelson
BACKGROUND: Cycle echocardiography (CE) is recommended for non-invasive diagnosis of diastolic dysfunction, but can be limited by respiratory and movement artifact. Isometric handgrip echocardiography (IHE) is also a robust diastolic discriminator, while avoiding the limitations associated with dynamic exercise. This study sought to compare these two diastolic stress testing approaches. METHODS: Twelve elderly individuals were recruited from the community (age: 71 + 6 years)...
May 10, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29744646/wound-complications-after-open-reduction-and-internal-fixation-of-tibial-plateau-fractures-in-the-elderly-a-multicentre-study
#19
Christopher L Gaunder, Zibin Zhao, Corey Henderson, Brandon R McKinney, Philip F Stahel, Boris A Zelle
PURPOSE: The incidence of wound complications after open reduction with internal fixation (ORIF) of tibial plateau fractures in young patients has been reported to range from approximately 5 to 15%. Reports on wound complication rates in the elderly patients are limited. This study investigates the incidence of post-operative wound complications in elderly patients undergoing ORIF of their tibial plateau fractures. METHODS: A retrospective study was performed within three accredited level 1 trauma centres...
May 9, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29743372/-breadth-and-functionality-of-varicella-zoster-virus-glycoprotein-specific-antibodies-identified-after-zostavax-vaccination-in-humans
#20
Nicole L Sullivan, Morgan A Reuter-Monslow, Janet Sei, Eberhard Durr, Carl W Davis, Cathy Chang, Megan McCausland, Andreas Wieland, David Krah, Nadine Rouphael, Aneesh K Mehta, Mark J Mulligan, Bali Pulendran, Rafi Ahmed, Kalpit A Vora
Herpes zoster (HZ/shingles) is the clinical manifestation of varicella zoster virus (VZV) reactivation. HZ typically develops as people age due to decreased cell-mediated immunity. However, the importance of antibodies for immunity against HZ prevention remains to be understood. The goal of this study was to examine the breadth and functionality of VZV-specific antibodies after vaccination with a live attenuated HZ vaccine (Zostavax). Direct enumeration of VZV-specific antibody secreting cells (ASC) via ELISPOT showed that Zostavax can induce both IgG and IgA ASCs seven days after vaccination, but not IgM ASCs...
May 9, 2018: Journal of Virology
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