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https://www.readbyqxmd.com/read/28441276/augs-consensus-statement-association-of-anticholinergic-medication-use-and-cognition-in-women-with-overactive-bladder
#1
(no author information available yet)
Overactive bladder affects a significant portion of the overall population and has substantial impact on daily activities and quality-of-life. When considering treatment, behavioral therapies should be instituted first, followed by medical therapies. Anticholinergic medications and beta-3 agonists are often used as initial pharmacologic therapy, but caution should be taken in prescribing anticholinergic medications in frail or cognitively impaired patients. Recently, concerns have developed regarding anticholinergic medications and the associated risk of cognitive impairment, dementia, and Alzheimer disease in the general population...
May 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28439843/effective-dose-estimation-for-oncological-and-neurological-pet-ct-procedures
#2
Josep M Martí-Climent, Elena Prieto, Verónica Morán, Lidia Sancho, Macarena Rodríguez-Fraile, Javier Arbizu, María J García-Velloso, José A Richter
BACKGROUND: The aim of this study was to retrospectively evaluate the patient effective dose (ED) for different PET/CT procedures performed with a variety of PET radiopharmaceutical compounds. PET/CT studies of 210 patients were reviewed including Torso (n = 123), Whole body (WB) (n = 36), Head and Neck Tumor (HNT) (n = 10), and Brain (n = 41) protocols with (18)FDG (n = 170), (11)C-CHOL (n = 10), (18)FDOPA (n = 10), (11)C-MET (n = 10), and (18)F-florbetapir (n = 10)...
December 2017: EJNMMI Research
https://www.readbyqxmd.com/read/28439842/controversies-in-the-multimodality-management-of-locally-advanced-rectal-cancer
#3
REVIEW
Robert Díaz Beveridge, Dilara Akhoundova, Gema Bruixola, Jorge Aparicio
Neoadjuvant radiotherapy previous to radical surgery, both as short-course radiotherapy and as long-course radiotherapy combined with 5-FU-based chemotherapy (LCRCT), is routinely used in the management of locally advanced rectal cancer, with consistent benefits in the reduction in the local relapse risk. Unfortunately, survival benefits have been elusive to demonstrate with this approach, especially in the setting of radical surgery in the form of total mesorectal excision (TME). Concerns about over-treating early-stage patients and about the possible long-term side effects have also cast more doubts in a blanket approach of treating all patients with neoadjuvant radiotherapy, especially with LCRCT...
June 2017: Medical Oncology
https://www.readbyqxmd.com/read/28437582/modified-frailty-index-predicts-postoperative-outcomes-in-older-gastrointestinal-cancer-patients
#4
Sarah A Vermillion, Fang-Chi Hsu, Robert D Dorrell, Perry Shen, Clancy J Clark
BACKGROUND AND OBJECTIVES: Frailty disproportionately impacts older patients with gastrointestinal cancer, rendering them at increased risk for poor outcomes. A frailty index may aid in preoperative risk stratification. We hypothesized that high modified frailty index (mFI) scores are associated with adverse outcomes after tumor resection in older, gastrointestinal cancer patients. METHODS: Patients (60-90 years old) who underwent gastrointestinal tumor resection were identified in the 2005-2012 NSQIP Participant Use File...
April 24, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28437320/development-of-a-claims-based-frailty-indicator-anchored-to-a-well-established-frailty-phenotype
#5
Jodi B Segal, Hsien-Yen Chang, Yu Du, Jeremy D Walston, Michelle C Carlson, Ravi Varadhan
BACKGROUND: Fried and colleagues described a frailty phenotype measured in the Cardiovascular Health Study (CHS). This phenotype is manifest when ≥3 of the following are present: low grip strength, low energy, slowed waking speed, low physical activity, or unintentional weight loss. We sought to approximate frailty phenotype using only administrative claims data to enable frailty to be assessed without physical performance measures. STUDY DESIGN: We used the CHS cohort data linked to participants Medicare claims...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28431912/osteosarcopenic-obesity-prevalence-and-relation-with-frailty-and-physical-performance-in-middle-aged-and-older-women
#6
Claudia Szlejf, Lorena Parra-Rodríguez, Oscar Rosas-Carrasco
OBJECTIVES: The aims of this study were to determine the prevalence of osteosarcopenic obesity (OSO) and to investigate its association with frailty and physical performance in Mexican community-dwelling middle-aged and older women. DESIGN: Cross-sectional analysis of a prospective cohort. SETTING: The FraDySMex study, a 2-round evaluation of community-dwelling adults from 2 municipalities in Mexico City. PARTICIPANTS: Participants were 434 women aged 50 years or older, living in the designated area in Mexico City...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431425/the-association-of-frailty-with-outcomes-and-resource-use-after-emergency-general-surgery-a-population-based-cohort-study
#7
Daniel I McIsaac, Husein Moloo, Gregory L Bryson, Carl van Walraven
BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty is an important predictor of adverse outcomes in older surgical patients. The population-level effect of frailty on EGS is poorly described. Therefore, our objective was to measure the association of preoperative frailty with outcomes in a population of older patients undergoing EGS. METHODS: We created a population-based cohort study using linked administrative data in Ontario, Canada, that included community-dwelling individuals aged >65 years having EGS...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430963/integrated-care-for-older-populations-and-its-implementation-facilitators-and-barriers-a-rapid-scoping-review
#8
Diane E Threapleton, Roger Y Chung, Samuel Y S Wong, Eliza Wong, Patsy Chau, Jean Woo, Vincent C H Chung, Eng-Kiong Yeoh
Purpose: Inform health system improvements by summarizing components of integrated care in older populations. Identify key implementation barriers and facilitators. Data sources: A scoping review was undertaken for evidence from MEDLINE, the Cochrane Library, organizational websites and internet searches. Eligible publications included reviews, reports, individual studies and policy documents published from 2005 to February 2017. Study selection: Initial eligible documents were reviews or reports concerning integrated care approaches in older/frail populations...
April 20, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28428725/tumor-biopsy-and-patient-enrollment-in-clinical-trials-for-advanced-hepatocellular-carcinoma
#9
Lorenza Rimassa, Maria Reig, Giovanni Abbadessa, Markus Peck-Radosavljevic, William Harris, Vittorina Zagonel, Davide Pastorelli, Elena Rota Caremoli, Camillo Porta, Nevena Damjanov, Hitendra Patel, Bruno Daniele, Maria Lamar, Brian Schwartz, Terri Goldberg, Armando Santoro, Jordi Bruix
Tumor biopsies may help to reliably distinguish hepatocellular carcinoma (HCC) from other tumors, mostly cholangiocarcinoma as well as to identify the patient populations who most benefit from target-driven HCC treatments, in order to improve the success rate of experimental therapies. Clarifying tumor biology may also lead to identify biomarkers with prognostic role and/or enabling to predict response or resistance to therapies. Recently, clinical trials have more efficiently included biomarker endpoints and increasingly collected tumor tissue from enrolled patients...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28427345/variation-in-gp-decisions-on-antihypertensive-treatment-in-oldest-old-and-frail-individuals-across-29-countries
#10
Sven Streit, Marjolein Verschoor, Nicolas Rodondi, Daiana Bonfim, Robert A Burman, Claire Collins, Gerasimovska Kitanovska Biljana, Sandra Gintere, Raquel Gómez Bravo, Kathryn Hoffmann, Claudia Iftode, Kasper L Johansen, Ngaire Kerse, Tuomas H Koskela, Sanda Kreitmayer Peštić, Donata Kurpas, Christian D Mallen, Hubert Maisoneuve, Christoph Merlo, Yolanda Mueller, Christiane Muth, Marija Petek Šter, Ferdinando Petrazzuoli, Thomas Rosemann, Martin Sattler, Zuzana Švadlenková, Athina Tatsioni, Hans Thulesius, Victoria Tkachenko, Peter Torzsa, Rosy Tsopra, Tuz Canan, Rita P A Viegas, Shlomo Vinker, Margot W M de Waal, Andreas Zeller, Jacobijn Gussekloo, Rosalinde K E Poortvliet
BACKGROUND: In oldest-old patients (>80), few trials showed efficacy of treating hypertension and they included mostly the healthiest elderly. The resulting lack of knowledge has led to inconsistent guidelines, mainly based on systolic blood pressure (SBP), cardiovascular disease (CVD) but not on frailty despite the high prevalence in oldest-old. This may lead to variation how General Practitioners (GPs) treat hypertension. Our aim was to investigate treatment variation of GPs in oldest-olds across countries and to identify the role of frailty in that decision...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28424612/an-examination-of-brain-abnormalities-and-mobility-in-individuals-with-mild-cognitive-impairment-and-alzheimer-s-disease
#11
Barbara L Fischer, Rhonda Bacher, Barbara B Bendlin, Alex C Birdsill, Martina Ly, Siobhan M Hoscheidt, Richard J Chappell, Jane E Mahoney, Carey E Gleason
Background: Mobility changes are concerning for elderly patients with cognitive decline. Given frail older individuals' vulnerability to injury, it is critical to identify contributors to limited mobility. Objective: To examine whether structural brain abnormalities, including reduced gray matter volume and white matter hyperintensities, would be associated with limited mobility among individuals with cognitive impairment, and to determine whether cognitive impairment would mediate this relationship. Methods: Thirty-four elderly individuals with mild cognitive impairment (MCI) and Alzheimer's disease underwent neuropsychological evaluation, mobility assessment, and structural brain neuroimaging...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28424183/biomarker-calibrated-nutrient-intake-and-healthy-diet-index-associations-with-mortality-risks-among-older-and-frail-women-from-the-women-s-health-initiative
#12
Oleg Zaslavsky, Shira Zelber-Sagi, James R Hebert, Susan E Steck, Nitin Shivappa, Fred K Tabung, Michael D Wirth, Yunqi Bu, James M Shikany, Tonya Orchard, Robert B Wallace, Linda Snetselaar, Lesley F Tinker
Background: Although studies to date have confirmed the association between nutrition and frailty, the impact of dietary intake and dietary patterns on survivorship in those with frailty is yet to be examined in a well-powered cohort with validated frailty status. Moreover, previous studies were limited by measurement error from dietary self-reports.Objective: We derived biomarker-calibrated dietary energy and protein intakes to address dietary self-report error. Using these data, we then evaluated the association of mortality in older women with frailty and dietary intake and healthy diet indexes, such as the alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII)...
April 19, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28422280/integrating-frailty-research-into-the-medical-specialties-report-from-a-u13-conference
#13
Jeremy Walston, Thomas N Robinson, Susan Zieman, Frances McFarland, Christopher R Carpenter, Keri N Althoff, Melissa K Andrew, Caroline S Blaum, Patrick J Brown, Brian Buta, E Wesley Ely, Luigi Ferrucci, Kevin P High, Stephen B Kritchevsky, Kenneth Rockwood, Kenneth E Schmader, Felipe Sierra, Kaycee M Sink, Ravi Varadhan, Arti Hurria
Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency virus care, and nephrology, and in the behavioral and social sciences. Lack of a consensus definition, proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for frail individuals hinders incorporation of frailty assessment and frailty research into the specialties...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28422251/-anti-michael-addition-of-grignard-reagents-to-sulfonylacetylenes-synthesis-of-alkynes
#14
Francisco Esteban, Lazhar Boughani, José L García Ruano, Alberto Fraile, José Alemán
In this work, the addition of Grignard reagents to arylsulfonylacetylenes, which undergoes an "anti-Michael addition", resulting in their alkynylation under very mild conditions is described. The simplicity of the experimental procedure and the functional group tolerance are the main features of this methodology. This is an important advantage over the use of organolithium at -78 °C that we previously reported. Moreover, the synthesis of diynes and other examples showing functional group tolerance in this anti-Michael reaction is also presented...
April 19, 2017: Organic & Biomolecular Chemistry
https://www.readbyqxmd.com/read/28421192/exercise-and-protein-intake-a-synergistic-approach-against-sarcopenia
#15
REVIEW
Anna Maria Martone, Emanuele Marzetti, Riccardo Calvani, Anna Picca, Matteo Tosato, Luca Santoro, Angela Di Giorgio, Antonio Nesci, Alex Sisto, Angelo Santoliquido, Francesco Landi
Sarcopenia, the age-dependent loss of muscle mass and function/strength, is increasingly recognized as a major risk factor for adverse outcomes in frail older people. As such, the skeletal muscle is a relevant target for interventions aimed at preventing or postponing the occurrence of negative health-related events in late life. The association among physical inactivity, insufficient intake of energy and protein, and poor muscle health in older adults suggests that physical exercise and targeted nutritional supplementation may offer substantial therapeutic gain against sarcopenia and its negative correlates...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28420723/mitochondrial-bax-determines-the-predisposition-to-apoptosis-in-human-aml
#16
Frank Reichenbach, Cornelius Wiedenmann, Enrico Schalk, Diana Becker, Kathrin Funk, Peter Scholz-Kreisel, Franziska Todt, Denise Wolleschak, Konstanze Dohner, Jens U Marquardt, Florian Heidel, Frank Edlich
Purpose: Cell-to-cell variability in apoptosis signaling contributes to heterogenic responses to cytotoxic stress in clinically heterogeneous neoplasia, such as acute myeloid leukemia (AML). The BCL-2 proteins BAX and BAK can commit mammalian cells to apoptosis and are inhibited by retrotranslocation from the mitochondria into the cytosol. The subcellular localization of BAX and BAK could determine the cellular predisposition to apoptotic death. Experimental design: The relative localization of BAX and BAK was determined by fractionation of AML cell lines and patient samples of a test cohort and a validation cohort...
April 18, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28420687/home-visits-to-frail-elderly-can-save-money-and-angst
#17
Brit Cooper-Jones, Katelyn Verstraten
No abstract text is available yet for this article.
April 18, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
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
#18
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/28419042/geriatric-fracture-care-future-trajectories-a-2015-aoa-critical-issues-symposium
#19
Julie A Switzer, Kevin J Bozic, Stephen L Kates
The population of the United States and the world is aging rapidly. Musculoskeletal care for older adults will be impacted by the manner in which health care is financed and the ability of the orthopaedic community to provide evidence-based integrated care for this population. We review the financial aspects of health-care reform and the implications for musculoskeletal care in the elderly. We discuss the establishment of quality measures for hip fracture care in the elderly, team building to accomplish this, and an innovative program designed to provide orthopaedic care to the frail elderly outside of the usual office setting...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418196/clinical-frailty-is-independently-associated-with-non-prescription-of-anticoagulants-in-older-patients-with-atrial-fibrillation
#20
Isuru Induruwa, Nicholas R Evans, Ayesha Aziz, Snigdha Reddy, Kayvan Khadjooi, Roman Romero-Ortuno
AIM: Anticoagulants are underused in older patients with atrial fibrillation (AF). Scoring systems, such as CHA2 DS2 -VASc and HAS-BLED, are recommended to guide clinicians in anticoagulation decisions, but patients' frailty might be an underrecognized factor. We investigated the association between the Clinical Frailty Scale (CFS) and community anticoagulant prescribing habits in patients aged ≥75 years with AF admitted acutely to hospital. METHODS: Data were gathered retrospectively over 3 months on individuals admitted under a medical team to a tertiary teaching hospital in the UK...
April 18, 2017: Geriatrics & Gerontology International
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