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https://www.readbyqxmd.com/read/28293557/sepsis-and-immunosenescence-in-the-elderly-patient-a-review
#1
REVIEW
Silvia Martín, Alba Pérez, Cesar Aldecoa
Sepsis is a prevalent, serious medical condition with substantial mortality and a significant consumption of health-care resources. Its incidence has increased around 9% annually in general population over the last years and specially in aged patients group. Several risk factors such as comorbidities, preadmission status, malnutrition, frailty, and an impared function in the immune system called immunosenescence are involved in the higher predisposition to sepsis in the elderly patients. Immunosenescence status consists in a functional impairment in both cell-mediated immunity and humoral immune responses and increases not only the risk for develop sepsis but also lead to more severe presentation of infection and may be is also related with a higher mortality...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28285121/a-novel-rehabilitation-intervention-for%C3%A2-older-patients-with-acute-decompensated%C3%A2-heart-failure-the-rehab-hf-pilot-study
#2
Gordon R Reeves, David J Whellan, Christopher M O'Connor, Pamela Duncan, Joel D Eggebeen, Timothy M Morgan, Leigh Ann Hewston, Amy Pastva, Mahesh J Patel, Dalane W Kitzman
OBJECTIVES: This study sought to assess a novel physical rehabilitation intervention in older patients hospitalized for acute decompensated heart failure (ADHF). BACKGROUND: After ADHF, older patients, who are frequently frail with multiple comorbidities, have prolonged and incomplete recovery of physical function and remain at high risk for poor outcomes. METHODS: The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) pilot study was a 3-site, randomized, attention-controlled pilot study of a tailored, progressive, multidomain physical rehabilitation intervention beginning in the hospital and continuing for 12 weeks post-discharge in patients ≥60 years hospitalized with ADHF...
March 5, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28268476/heart-rate-independent-qt-variability-component-can-detect-subclinical-cardiac-autonomic-neuropathy-in-diabetes
#3
Mohammad H Imam, Chandan K Karmakar, Ahsan H Khandoker, Herbert F Jelinek, M Palaniswami
Cardiac autonomic neuropathy (CAN) may lead to life threatening arrhythmia due to denervation of both the parasympathetic and sympathetic branches of autonomic nervous system innervating the heart. CAN is a frequently under diagnosed complication of diabetes, because a patient can have asymptomatic CAN for several years before it is clinically apparent. However, detection of CAN at the early or subclinical stage leads to more effective treatment outcomes. Cardiac autonomic reflex tests (CART) (i.e. Ewing test battery) are normally used for the detection and staging of CAN...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267466/rehabilitation-therapy-in-older-acute-heart-failure-patients-rehab-hf-trial-design-and-rationale
#4
Gordon R Reeves, David J Whellan, Pamela Duncan, Christopher M O'Connor, Amy M Pastva, Joel D Eggebeen, Leigh Ann Hewston, Timothy M Morgan, Shelby D Reed, W Jack Rejeski, Robert J Mentz, Paul B Rosenberg, Dalane W Kitzman
BACKGROUND: Acute decompensated heart failure (ADHF) is a leading cause of hospitalization in older persons in the United States. Reduced physical function and frailty are major determinants of adverse outcomes in older patients with hospitalized ADHF. However, these are not addressed by current heart failure (HF) management strategies and there has been little study of exercise training in older, frail HF patients with recent ADHF. HYPOTHESIS: Targeting physical frailty with a multi-domain structured physical rehabilitation intervention will improve physical function and reduce adverse outcomes among older patients experiencing a HF hospitalization...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28265844/frailty-as-a-risk-predictor-of-morbidity-and-mortality-following-liver-surgery
#5
Faiz Gani, Marcelo Cerullo, Neda Amini, Stefan Buettner, Georgios A Margonis, Kazunari Sasaki, Yuhree Kim, Timothy M Pawlik
BACKGROUND: Given the increasing number of elderly and comorbid patients undergoing surgery, there is increased interest in preoperatively identifying patients at high risk of morbidity and mortality following liver resection. We sought to develop and validate the use of a frailty index (FI) to predict poor postoperative outcomes following liver surgery. METHODS: Patients undergoing a liver resection were identified using the National Surgical Quality Improvement Program Hepatectomy-targeted database for 2014 and randomized into a training or validation cohort...
March 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28265210/transcatheter-aortic-valve-replacement-comprehensive-review-and-present-status
#6
REVIEW
Sameer Arora, Jacob A Misenheimer, Radhakrishnan Ramaraj
Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28263377/the-frailty-phenotype-and-palliative-care-needs-of-older-survivors-of-critical-illness
#7
Lauren R Pollack, Nathan E Goldstein, Wendy C Gonzalez, Craig D Blinderman, Mathew S Maurer, David J Lederer, Matthew R Baldwin
OBJECTIVES: To assess symptoms in older intensive care unit (ICU) survivors and determine whether post-ICU frailty identifies those with the greatest palliative care needs. DESIGN: A prospective cohort study. SETTING: Urban tertiary care hospital and community hospital. PARTICIPANTS: Medical ICU survivors of mechanical ventilation aged 65 and older (N = 125). MEASUREMENTS: Baseline measurements of the Edmonton Symptom Assessment Scale (ESAS), categorized as mild (0-3), moderate (4-6), and severe (7-10), and the frailty phenotype were made during the week before hospital discharge...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28244554/body-mass-index-and-its-relationship-with-disability-chronic-diseases-and-frailty-in-older-people-a-comparison-of-the-lipschitz-and-who-classifications
#8
F P A S Pessanha, L P Lustosa, J A O Carneiro, K Pfrimer, P G Fassini, N M C Alves, T L Pontes, J C Moriguti, N K C Lima, E Ferriolli
BACKGROUND: Anthropometric parameters are closely associated with the pathophysiology of frailty and with clinic and functional parameters assessed for its diagnosis. OBJECTIVE: To evaluate the possible association of the nutritional status of older people as assessed by Body Mass Index (BMI) and functional disability, self-reported chronic diseases and frailty, comparing the use of two different classifications of BMI. DESIGN: Cross-sectional study...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28242771/improving-outcomes-from-high-risk-surgery-a-multimethod-evaluation-of-a-patient-centred-advanced-care-planning-intervention
#9
Amanda Selwood, Siva Senthuran, Brette Blakely, Paul Lane, John North, Robyn Clay-Williams
INTRODUCTION: Patients who are frail, have multiple comorbidities or have a terminal illness often have poor outcomes from surgery. However, sole specialists may recommend surgery in these patients without consultation with other treating clinicians or allowing for patient goals. The Patient-Centred Advanced Care Planning (PC-ACP) model of care provides a framework in which a multidisciplinary advanced care plan is devised to incorporate high-risk patients' values and goals. Decision-making is performed collaboratively by patients, their family, surgeons, anaesthetists, intensivists and surgical case managers...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28242192/screening-for-frailty-and-sarcopenia-among-older-persons-in-medical-outpatient-clinics-and-its-associations-with-healthcare-burden
#10
Li Feng Tan, Zhen Yu Lim, Rachel Choe, Santhosh Seetharaman, Reshma Merchant
OBJECTIVES: With an aging population and increase in multimorbidity, the importance of screening for frailty and sarcopenia has become a public health priority. Several tools to do so exist. This study aimed to examine whether the SARC-F and Edmonton frail screening tools are useful in clinical practice to identify at-risk patients for negative health outcomes who would benefit from intervention. DESIGN: This is a cross-sectional study of patients attending medical specialist outpatient clinics at the National University Hospital, Singapore from May 2015 to February 2016...
February 24, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28229926/the-role-of-frailty-in-explaining-the-association-between-the-metabolic-syndrome-and-mortality-in-older-adults
#11
Emiel O Hoogendijk, Martijn Huisman, Adriana J van Ballegooijen
The association between the metabolic syndrome (MetS) and adverse outcomes in older adults may be explained by other health conditions. This study examined the role of frailty in explaining the association between MetS and mortality, independent of comorbidity. Data were used from 1247 men and women aged ≥65years of the Longitudinal Aging Study Amsterdam. MetS was assessed using the definition of the US National Cholesterol Education Program. Frailty was measured by the frailty phenotype. Mortality was monitored from 1995 until 2015...
February 14, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28228654/low-ft3-a-possible-marker-of-frailty-in-the-elderly
#12
Aldo Bertoli, Alessia Valentini, Maria Assunta Cianfarani, Elena Gasbarra, Umberto Tarantino, Massimo Federici
INTRODUCTION: Frailty is associated with a functional decline of multiple physiological systems, of which they may be a cause or consequence. The objective of the study was to evaluate the prevalence of thyroid hormone modifications in elderly frail subjects and its relationship with frailty. STUDY POPULATION AND METHODS: An observational study was carried out at the University Hospital "Tor Vergata" in Rome among ambulatory and hospitalized patients. The study population consisted of 112 elderly subjects: 62 were hospitalized following hip fracture and 50 control subjects were outpatients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28228632/physical-and-psychological-characteristics-of-the-community-dwelling-elderly-with-heart-disease
#13
Takeshi Kera, Hisashi Kawai, Hideyo Yoshida, Hirohiko Hirano, Motonaga Kojima, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi
Objectives Although the survival rates of patients with heart diseases, such as myocardial infarction and heart failure, have increased, the incidence of heart disease in elderly individuals has also increased. We compared characteristics of the community-dwelling elderly with heart diseases (heart disease group) and without heart diseases (non-heart disease group).Methods A total of 758 elderly individuals participated in our survey ("Otassha-kensin") in 2014. The heart disease group (47 men, 28 women) and the non-heart disease group (263 men, 420 women) were selected from among these participants...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/28226649/heart-rate-independent-qt-variability-component-can-detect-subclinical-cardiac-autonomic-neuropathy-in-diabetes
#14
Mohammad H Imam, Chandan K Karmakar, Ahsan H Khandoker, Herbert F Jelinek, M Palaniswami, Mohammad H Imam, Chandan K Karmakar, Ahsan H Khandoker, Herbert F Jelinek, M Palaniswami, Ahsan H Khandoker, Herbert F Jelinek, Chandan K Karmakar, Mohammad H Imam, M Palaniswami
Cardiac autonomic neuropathy (CAN) may lead to life threatening arrhythmia due to denervation of both the parasympathetic and sympathetic branches of autonomic nervous system innervating the heart. CAN is a frequently under diagnosed complication of diabetes, because a patient can have asymptomatic CAN for several years before it is clinically apparent. However, detection of CAN at the early or subclinical stage leads to more effective treatment outcomes. Cardiac autonomic reflex tests (CART) (i.e. Ewing test battery) are normally used for the detection and staging of CAN...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226343/-diagnosis-and-risk-assessment-of-postoperative-complications-of-gastric-cancer-in-japan-and-korea
#15
Xiang Hu, Chi Zhang
Radical surgery of gastric cancer (D2 lymph node dissection) as the standard operation is widely used in clinical practice and satisfactory prognosis can be obtained in patients who receive radical gastrectomy. But surgical invasion can cause high morbidity of complications and mortality. The data of large-scale evidence-based medical clinical trials and large databases in Japan and Korea showed that anastomotic leakage, pancreatic leakage and abdominal abscess were the most common complications after gastrectomy, and the morbidity of complication was about 20% and mortality was about 1%...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225718/frailty-and-circulating-markers-of-inflammation-in-hiv-and-hiv-men-in-the-multicenter-aids-cohort-study
#16
Joseph B Margolick, Jay H Bream, Otoniel Martínez-Maza, Joe Lopez, Xiuhong Li, John P Phair, Susan L Koletar, Lisa P Jacobson
BACKGROUND: Frailty is associated with immune activation and inflammation in the elderly general population, but whether this is true in the younger HIV-infected (HIV+) population is not known. METHODS: We analyzed 24 serologic biomarkers of monocyte, T-cell, or B-cell activation in HIV- (n = 207) and HIV+ (n = 714; 75% virologically suppressed) men who have sex with men in the Multicenter AIDS Cohort Study (MACS) and were classified as frail or nonfrail according to expression or nonexpression of the frailty phenotype at 2 consecutive study visits...
April 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28223787/comparing-the-predictive-accuracy-of-frailty-comorbidity-and-disability-for-mortality-a-1-year-follow-up-in-patients-hospitalized-in-geriatric-wards
#17
Martin Ritt, Julia Isabel Ritt, Cornel Christian Sieber, Karl-Günter Gaßmann
BACKGROUND: Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited. OBJECTIVE: This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients. DESIGN: Prospective cohort study. PATIENTS AND SETTING: A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#18
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28190748/modified-frailty-index-associated-with-clavien-dindo-iv-complications-in-robot-assisted-radical-prostatectomies-a-retrospective-study
#19
Isaiah Levy, Mark Finkelstein, Khawaja Hassan Bilal, Michael Palese
OBJECTIVE: To determine the effect of frailty on patient outcomes including any complication, Clavien-Dindo IV (CDIV) (intensive care unit-level) complications, and 30-day mortality for robotic-assisted radical prostatectomies (RARP) patients in comparison to other predictive indices using the modified frailty index (mFI). MATERIAL AND METHODS: Patients undergoing RARP from 2008 to 2014 for a prostate cancer-related diagnosis were queried using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
February 9, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28190681/differential-effects-of-metformin-on-age-related-comorbidities-in-older-men-with-type-2-diabetes
#20
Chen-Pin Wang, Carlos Lorenzo, Samy L Habib, Booil Jo, Sara E Espinoza
AIMS: To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC naïve initially, and assess the heterogeneous effects of metformin on ARCs and mortality. METHODS: We identified a clinical cohort of male veterans in the United States who were ≥65years old with T2D and free from ARCs during 2002-2003...
April 2017: Journal of Diabetes and its Complications
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