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https://www.readbyqxmd.com/read/27920475/impact-of-frailty-on-approach-to-colonic-resection-laparoscopy-vs-open-surgery
#1
Catalina Mosquera, Konstantinos Spaniolas, Timothy L Fitzgerald
AIM: To understand the influence of frailty on postoperative outcomes for laparoscopic and open colectomy. METHODS: Data were obtained from the National Surgical Quality Improvement Program (2005-2012) for patients undergoing colon resection [open colectomy (OC) and laparoscopic colectomy (LC)]. Patients were classified as non-frail (0 points), low frailty (1 point), moderate frailty (2 points), and severe frailty (≥ 3) using the Modified Frailty Index. 30-d mortality and complications were used as the primary end point and analyzed for the overall population...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27919145/-development-of-a-predictive-model-of-death-or-urgent-hospitalization-to-identify-frail-elderly
#2
Paolo Pandolfi, Natalina Collina, Paolo Marzaroli, Elisa Stivanello, Muriel Assunta Musti, Chiara Giansante, Vincenza Perlangeli, Lorenzo Pizzi, Sara De Lisio, Fausto Francia
OBJECTIVES: to develop and validate a predictive model of mortality or emergency hospitalization in all subjects aged 65 years and over. DESIGN: cohort study based on 9 different databases linked with each other. SETTING AND PARTICIPANTS: the model was developed on the population aged 65 years and over resident at 01.01.2011 for at least two years in the city of Bologna (Emilia-Romagna Region, Northern Italy); 96,000 persons were included...
November 2016: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/27918919/efficiency-measurement-and-monte-carlo-simulations-of-a-cebr3-scintillator
#3
E Picado, M Carmona-Gallardo, J Cal-González, L M Fraile, H Mach, J M Udías, V Vedia
CeBr3 crystals meet many of the demands of high performance scintillators, due to their excellent timing properties, good effective Z and high photon yield. It is important to characterize their efficiency and to verify whether modern Monte Carlo codes are reliable enough to reproduced the observed values. We report here on the measurement of both total and photopeak efficiency of a 1" diameter×1" height CeBr3 crystal for gamma-ray energies up to 1.4MeV at several distances, using a variety of low energy gamma rays sources...
November 23, 2016: Applied Radiation and Isotopes
https://www.readbyqxmd.com/read/27917714/antiplatelet-and-anticoagulation-treatment-in-patients-with-thrombocytopenia
#4
Nuccia Morici, Silvia Cantoni, Paola Vallerio, Marco Cattaneo, Stefano Savonitto
Thrombocytopenia (TP) is a common finding in patients hospitalized for cardiovascular causes and needing antiplatelet and anticoagulant therapies. However, TP is not only a numeric parameter, but mostly a dynamic condition affected by the patients' underlying disorders and concomitant treatments. Platelets are important players in the hemostatic process, taking part to both primary and secondary hemostasis. Although both TP and antithrombotic treatment contribute to the risk of bleeding, the complexity of the pathogenesis of bleeding events makes it difficult to predict them accurately simply based on these two parameters...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27917261/anti-hepatitis-c-virus-drugs-and-kidney
#5
REVIEW
Paul Carrier, Marie Essig, Marilyne Debette-Gratien, Denis Sautereau, Annick Rousseau, Pierre Marquet, Jérémie Jacques, Véronique Loustaud-Ratti
Hepatitis C virus (HCV) mainly targets the liver but can also induce extrahepatic manifestations. The kidney may be impacted via an immune mediated mechanism or a cytopathic effect. HCV patients are clearly at a greater risk of chronic kidney disease (CKD) than uninfected patients are, and the presence of CKD increases mortality. Interferon-based therapies and ribavirin are difficult to manage and are poorly effective in end-stage renal disease and hemodialysis. These patients should be given priority treatment with new direct anti-viral agents (DAAs) while avoiding peginterferon and ribavirin...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#6
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27914495/quantitative-increase-in-frailty-is-associated-with-diminished-survival-after-transcatheter-aortic-valve-replacement
#7
Dhaval Chauhan, Nicky Haik, Aurelie Merlo, Bruce J Haik, Chunguang Chen, Marc Cohen, Anne Mosenthal, Mark Russo
BACKGROUND: The purpose of this study is to assess the impact of frailty index comprised of commonly used frailty metrics on outcomes following transcatheter aortic valve replacement (TAVR) outcomes, including mortality, length of stay, and discharge destination. METHODS AND RESULTS: Retrospective data collection was performed for 342 consecutive patients who underwent TAVR at a single center from May 15, 2012, to September 17, 2015. Frailty index score was calculated using 15-ft walk test, Katz activities of daily living, preoperative serum albumin, and dominant handgrip strength...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#8
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910810/production-of-tnf-alpha-ex-vivo-is-predictive-of-an-immune-response-to-flu-vaccination-in-a-frail-elderly-population
#9
Frédéric Bloch, Bénédicte Charmeteau, Michael Tovey, Jean-François Meritet, Corinne Desaint, Odile Launay, Pierre Lebon
OBJECTIVE: To investigate the relationship between the response to influenza vaccination and the ability to produce proinflamatory cytokines in elderly subjects. METHODS: Whole blood samples from 25 elderly subjects collected before influenza vaccination were stimulated with the influenza vaccine in order to evaluate the secretion of five specific cytokines: TNFα, IFNα, IFNγ, IL2 and IL10. The results were correlated with the increased HAI antibody titres two weeks after vaccination...
September 1, 2016: European Cytokine Network
https://www.readbyqxmd.com/read/27909934/current-achievements-and-future-perspectives-of-metronomic-chemotherapy
#10
REVIEW
Adriana Romiti, Rosa Falcone, Michela Roberto, Paolo Marchetti
In recent years, many anticancer drugs have been tested at metronomic dosages for a variety of tumours. Mechanisms of action attributed to metronomic chemotherapy (MCT) include antiangiogenesis, immunomodulation, direct inhibition of tumour growth, effect on tumour initiating cells and the modulation of clonal evolution. An active clinical research, aimed at testing MCT in several cancers, has been conducted over the past 15 years. However, because the majority of available results come from earlier phase II studies, mainly performed in the area of breast cancer (BC), it is clear that there are areas still to be investigated...
December 1, 2016: Investigational New Drugs
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#11
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#12
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27908316/-frail-patients-and-surgery
#13
Nadia A Henriksen, Frederik Helgstrand, Ismail Gögenur
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function...
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27904234/allocation-of-rehabilitation-services-for-older-adults-in-the-ontario-home-care-system
#14
Joshua J Armstrong, Joanie Sims-Gould, Paul Stolee
Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27903588/discovery-and-validation-of-agonistic-angiotensin-receptor-autoantibodies-as-biomarkers-of-adverse-outcomes
#15
Peter Abadir, Alka Jain, Laura Powell, Qian-Li Xue, Jing Tian, Robert G Hamilton, David Bennett, Thomas Finucane, Jeremy D Walston, Neal S Fedarko
BACKGROUND: -Agonistic angiotensin II type I receptor autoantibodies (AT1RaAbs) have not been associated with functional measures or risk for adverse health outcomes. AT1RaAbs could be utilized to stratify patient risk and to identify patients who can benefit from angiotensin receptor blocker (ARB) treatment. METHODS: -Demographic and physiologic covariates were measured in a discovery set of community dwelling adults from Baltimore (N=255) and AT1RaAb associations with physical function tests and outcomes assessed...
November 30, 2016: Circulation
https://www.readbyqxmd.com/read/27903307/the-cumulative-effect-of-frailty-and-cognition-on-mortality-results-of-a-prospective-cohort-study
#16
Philip D St John, Suzanne L Tyas, Lauren E Griffith, Verena Menec
BACKGROUND: Both physical frailty and cognitive impairment predict death, but the joint effect of these two factors is uncertain. The objectives are to determine if the Mini-mental state examination (MMSE) and the Frailty Index (FI) predict death over a five-year interval after accounting for the effect of the other; and if there is an interaction in this effect. METHODS: An analysis of an existing prospective cohort study of 1,751 community living older adults followed over a five-year time frame...
December 1, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27902891/computerized-agility-training-improves-change-of-direction-and-balance-performance-independently-of-footwear-in-young-adults
#17
Max R Paquette, Brian K Schilling, Joshua D Bravo, Shelby A Peel, Yuhua Li, Robert J Townsend
: Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. PURPOSE: This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. METHOD: Thirty recreationally active young adults (Mage = 22.8 ± 3.1 years; Mheight = 1.71 ± 0.7 m; Mbodymass = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes...
November 30, 2016: Research Quarterly for Exercise and Sport
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#18
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#19
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27901241/cardiovascular-risk-factors-associated-with-frailty-syndrome-among-hospitalized-elderly-people-a-cross-sectional-study
#20
Darlene Mara Dos Santos Tavares, Camila Gigante Colamego, Maycon Sousa Pegorari, Pollyana Cristina Dos Santos Ferreira, Flávia Aparecida Dias, Alisson Fernandes Bolina
CONTEXT AND OBJECTIVE: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING: Observational cross-sectional study in a public teaching hospital...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
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