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https://www.readbyqxmd.com/read/28340246/considerations-on-glycaemic-control-in-older-and-or-frail-individuals-with-diabetes-and-advanced-kidney-disease
#1
Nicolae Mircea Panduru, Ionut Nistor, Per-Henrik Groop, Wim Van Biesen, Ken Farrington, Adrian Covic
The increasing prevalence of chronic kidney disease (CKD) and diabetes over the last decade has resulted in increasing numbers of frail older patients with a combination of these conditions. Current treatment guidelines may not necessarily be relevant for such patients, who are mostly excluded from the trials upon which these recommendations are based. There is a paucity of data upon which to base the management of older patients with CKD. Nearly all current guidelines recommend less-tight glycaemic control for the older population, citing the lack of proven medium-term benefits and concerns about the high short-term risk of hypoglycaemia...
March 13, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28340242/insertion-of-miniaturized-cardiac-monitors-outside-the-catheter-operating-room-experience-and-practical-advice
#2
Jan Steffel, David Jay Wright, Harald Schäfer, Tabinda Rashid-Fadel, Thorsten Lewalter
Minor surgical procedures are increasingly being performed as outpatient procedures in settings outside hospital operating rooms (ORs). In electrophysiology, the recent miniaturization of insertable cardiac monitors (ICMs) has enabled the routine insertion of the device as a minimally invasive procedure without the need of a catheter OR. However, a shift to office-based environments for minor surgical procedures is associated with some concerns, particularly with respect to patient- and procedure-related safety in the new setting...
March 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339459/functional-classification-of-dna-variants-by-hybrid-minigenes-identification-of-30-spliceogenic-variants-of-brca2-exons-17-and-18
#3
Eugenia Fraile-Bethencourt, Beatriz Díez-Gómez, Valeria Velásquez-Zapata, Alberto Acedo, David J Sanz, Eladio A Velasco
Mutation screening of the breast cancer genes BRCA1 and BRCA2 identifies a large fraction of variants of uncertain clinical significance (VUS) whose functional and clinical interpretations pose a challenge for genomic medicine. Likewise, an increasing amount of evidence indicates that genetic variants can have deleterious effects on pre-mRNA splicing. Our goal was to investigate the impact on splicing of a set of reported variants of BRCA2 exons 17 and 18 to assess their role in hereditary breast cancer and to identify critical regulatory elements that may constitute hotspots for spliceogenic variants...
March 24, 2017: PLoS Genetics
https://www.readbyqxmd.com/read/28331738/sentinel-node-biopsy-in-special-histologic-types-of-invasive-breast-cancer
#4
Montserrat Solà, Mireia Recaj, Eva Castellà, Pere Puig, Josep Maria Gubern, Juan Francisco Julian, Manel Fraile
OBJECTIVE: To assess the feasibility of sentinel node biopsy (SNB) in ductal and lobular invasive breast cancer, a group of tumors known as special histologic type (SHT) of breast cancer. MATERIALS AND METHODS: Between January 1997 and July 2008, 2253 patients from 6 affiliated hospitals underwent SNB who had early breast cancer and clinically negative axilla. The patients' data were collected in a multicenter database. For lymphatic mapping, all patients received an intralesional dose of radiocolloid Tc-99m (4mCi in 0...
April 2016: J Breast Health (2013)
https://www.readbyqxmd.com/read/28331300/dementia-and-delirium-the-outcomes-in-elderly-hip-fracture-patients
#5
Christina A Mosk, Marnix Mus, Jos Pam Vroemen, Tjeerd van der Ploeg, Dagmar I Vos, Leon Hgj Elmans, Lijckle van der Laan
BACKGROUND: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium. METHODS: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#6
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28329858/cystatin-c-and-the-risk-of-frailty-and-mortality-in-older-men
#7
Allyson Hart, Terri L Blackwell, Misti L Paudel, Brent C Taylor, Eric S Orwoll, Peggy M Cawthon, Kristine E Ensrud
Background: This study examines the association between cystatin C (cysC) levels and risks of progression of frailty status or death in older men. Methods: Prospective study of 2,613 men without overt frailty aged 67 years and older enrolled in the MrOS ancillary sleep study. Baseline measurements included serum cysC, serum creatinine, and frailty status. Repeat frailty status, performed an average of 3.4 years later, was assessed as an ordinal outcome of robust, intermediate stage (prefrail), frail or dead...
November 9, 2016: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329314/sirt1-polymorphisms-and-serum-induced-sirt1-protein-expression-in-aging-and-frailty-the-champ-study
#8
Shajjia Razi, Victoria C Cogger, Marina Kennerson, Vicky L Benson, Aisling C McMahon, Fiona M Blyth, David J Handelsman, Markus J Seibel, Vasant Hirani, Vasikaran Naganathan, Louise Waite, Rafael de Cabo, Robert G Cumming, David G Le Couteur
The nutrient sensing protein, SIRT1 influences aging and nutritional interventions such as caloric restriction in animals, however, the role of SIRT1 in human aging remains unclear. Here, the role of SIRT1 single-nucleotide polymorphisms (SNPs) and serum-induced SIRT1 protein expression (a novel assay that detects circulating factors that influence SIRT1 expression in vitro) were studied in the Concord Health and Ageing in Men Project (CHAMP), a prospective cohort of community dwelling men aged 70 years and older...
March 14, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329311/comparative-effectiveness-of-high-dose-versus-standard-dose-influenza-vaccines-among-us-medicare-beneficiaries-in-preventing-postinfluenza-deaths-during-2012-2013-and-2013-2014
#9
David K Shay, Yoganand Chillarige, Jeffrey Kelman, Richard A Forshee, Ivo M Foppa, Michael Wernecke, Yun Lu, Jill M Ferdinands, Arjun Iyengar, Alicia M Fry, Chris Worrall, Hector S Izurieta
Background.: Recipients of high-dose vs standard-dose influenza vaccines have fewer influenza illnesses. We evaluated the comparative effectiveness of high-dose vaccine in preventing postinfluenza deaths during 2012-2013 and 2013-2014, when influenza viruses and vaccines were similar. Methods.: We identified Medicare beneficiaries aged ≥65 years who received high-dose or standard-dose vaccines in community-located pharmacies offering both vaccines. The primary outcome was death in the 30 days following an inpatient or emergency department encounter listing an influenza International of Classification of Diseases, Ninth Revision, Clinical Modification code...
March 2, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28329258/a-new-frailty-score-for-experimental-animals-based-on-the-clinical-phenotype-inactivity-as-a-model-of-frailty
#10
Mari Carmen Gomez-Cabrera, Rebeca Garcia-Valles, Leocadio Rodriguez-Mañas, Francisco Jose Garcia-Garcia, Gloria Olaso-Gonzalez, Andrea Salvador-Pascual, Francisco Jose Tarazona-Santabalbina, Jose Viña
The development of animal models to study human frailty is important to test interventions to be translated to the clinical practice. The aim of this work was to develop a score for frailty in experimental animals based in the human frailty phenotype. We also tested the effect of physical inactivity in the development of frailty as determined by our score. Male C57Bl/6J mice, individually caged, were randomly assigned to one of two groups: sedentary (inactive) or spontaneous wheel-runners. We compared the sedentary versus the active lifestyle in terms of frailty by evaluating the clinical criteria used in humans: unintentional weight loss; poor endurance (running time); slowness (running speed); weakness (grip strength), and low activity level (motor coordination) at five different ages: 17, 20, 23, 26 and 28 months of age...
January 19, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329224/a-clinically-relevant-frailty-index-for-aging-rats
#11
Marshall G Miller, Nopporn Thangthaeng, Barbara Shukitt-Hale
Frailty is a clinical syndrome that is increasingly prevalent during aging. Frailty involves the confluence of reduced strength, speed, physical activity, and endurance and is associated with adverse health outcomes. The present study adapts existing clinical and preclinical indices of frailty to the Fischer (F344) rat. Male F344 rats (n = 133; 17 mo) completed a battery of behavioral tasks, including forelimb wire suspension (strength), rotarod (speed), open field (physical activity), and inclined screen (endurance)...
January 21, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329145/higher-prevalence-of-frailty-among-a-sample-of-hiv-infected-middle-aged-and-older-chinese-adults-is-associated-with-neurocognitive-impairment-and-depressive-symptoms
#12
Yingying Ding, Haijiang Lin, Xing Liu, Frank Y Wong, Yan V Sun, Vincent C Marconi, Na He
We investigated the prevalence and correlates of prefrailty/frailty, determined on the basis of the Fried criteria, in Chinese patients with and those without human immunodeficiency virus (HIV) infection. HIV-infected patients were more likely to be frail or prefrail than controls, and this association remained significant after adjustment for potential confounders (odds ratio, 3.79). After additional adjustment for neurocognitive impairment and depressive and insomnia symptoms, this association remained significant but attenuated (odds ratio, 2...
March 16, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28329140/the-impact-of-frailty-on-patient-centered-outcomes-following-aortic-valve-replacement
#13
Brian R Kotajarvi, Marissa J Schafer, Elizabeth J Atkinson, Megan M Traynor, Charles J Bruce, Kevin L Greason, Rakesh M Suri, Jordan D Miller, Nathan K LeBrasseur
Background: Frailty confers risk for surgical morbidity and mortality. Whether patient-reported measures of health, well-being, or quality of life respond differently to surgery in non-frail and frail individuals is unknown. Methods: Older adults with severe aortic stenosis presenting for surgery were assessed for frailty using Cardiovascular Health Study Criteria. Patient-reported measures of functional capacity (Duke Activity Status Index [DASI]), physical and mental health (Medical Outcomes Study Short Form-Physical and Mental Component Scales [SF-12 PCS and SF-12 MCS, respectively]), well-being (linear analogue self-assessment [LASA]), and quality of life (LASA) were administered before and 3 months after surgery...
March 10, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329104/vascular-cerebral-damage-in-frail-older-adults-the-amimage-study
#14
José Alberto Avila-Funes, Amandine Pelletier, Céline Meillon, Gwénaëlle Catheline, Olivier Periot, Irene Trevin O-Frenk, Magali Gonzalez-Colaço, Jean-François Dartigues, Karine Pérès, Michèle Allard, Bixente Dilharreguy, Hélène Amieva
Background: Frailty has been associated with increased risk of adverse-health related outcomes including cognitive impairment. However, little is know about the pathogenesis relating frailty to cognitive decline. Therefore, the main objective of this study was to investigate the association between vascular cerebral damage and frailty. Methods: Cross-sectional study involving 176 community-dwelling participants aged 67-86 years, participating in the AMImage Study, an ancillary neuro-imaging project of the AMI cohort, a French prospective cohort including older farmers living in rural areas...
January 21, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28328387/-there-is-something-we-need-to-tell-you%C3%A2-communicating-health-screening-results-to-older-adults-via-the-internet
#15
Sander Beukema, Lex van Velsen, Stephanie Jansen-Kosterink, Joyce Karreman
BACKGROUND: With the introduction of online health screenings, guidelines describing how to communicate about a person's health need to be adapted for a digital setting. This study aimed to uncover older adults' preferences regarding such online messages. MATERIALS AND METHODS: Thirty older adults (aged 65 to 75 years) viewed four versions of the results message of a screening aimed at identifying frailty: a standard, empathic, tailored, or both empathic and tailored message...
February 16, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28326295/role-of-the-cytokine-like-hormone-leptin-in-muscle-bone-crosstalk-with-aging
#16
REVIEW
Mark W Hamrick
The cytokine-like hormone leptin is a classic adipokine that is secreted by adipocytes, increases with weight gain, and decreases with weight loss. Additional studies have, however, shown that leptin is also produced by skeletal muscle, and leptin receptors are abundant in both skeletal muscle and bone-derived mesenchymal (stromal) stem cells. These findings suggest that leptin may play an important role in muscle-bone crosstalk. Leptin treatment in vitro increases the expression of myogenic genes in primary myoblasts, and leptin treatment in vivo increases the expression of microRNAs involved in myogenesis...
February 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#17
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28325024/balance-quality-assessment-as-an-early-indicator-of-physical-frailty-in-older-people
#18
Aly Chkeir, Doha Safieddine, D Bera, M Collart, J L Novella, M Drame, David J Hewson, Jacques Duchene
Frailty is an increasingly common geriatric condition that results in an increased risk of adverse health outcomes such as falls. The most widely-used means of detecting frailty is the Fried phenotype, which includes several objective measures such as grip strength and gait velocity. One method of screening for falls is to measure balance, which can be done by a range of techniques including the assessment of the Centre of Pressure (CoP) during a balance assessment. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that can evaluate balance quality...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324124/osteoporosis-in-frail-patients-a-consensus-paper-of-the-belgian-bone-club
#19
REVIEW
E Gielen, P Bergmann, O Bruyère, E Cavalier, P Delanaye, S Goemaere, J-M Kaufman, M Locquet, J-Y Reginster, S Rozenberg, A-M Vandenbroucke, J-J Body
In this consensus paper, the Belgian Bone Club aims to provide a state of the art on the epidemiology, diagnosis, and management of osteoporosis in frail individuals, including patients with anorexia nervosa, patients on dialysis, cancer patients, persons with sarcopenia, and the oldest old. All these conditions may indeed induce bone loss that is superimposed on physiological bone loss and often remains under-recognized and under-treated. This is of particular concern because of the major burden of osteoporotic fractures in terms of morbidity, mortality, and economic cost...
March 21, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28323342/inflammatory-markers-and-frailty-in-long-term-care-residents
#20
Gabrielle A Langmann, Subashan Perera, Mary A Ferchak, David A Nace, Neil M Resnick, Susan L Greenspan
OBJECTIVES: To determine whether proinflammatory biomarkers are associated with frailty assessed according to functional status, mobility, mental health, and falls over 24 months. DESIGN: Secondary analysis of a 2-year double-blind clinical trial for osteoporosis. SETTING: Nursing homes and assisted living facilities. PARTICIPANTS: Women aged 65 and older with osteoporosis in long-term care (LTC) (N = 178). MEASUREMENTS: Baseline serum concentrations of proinflammatory cytokines and soluble receptors (high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNFα) and its two receptors (TNFα-R1 and TNFα-R2), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), IL-10), functional status assessed according to activities of daily living, the Nursing Home Physical Performance Test, gait speed, cognitive status, mental health, and falls...
March 21, 2017: Journal of the American Geriatrics Society
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