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Hospitalized older adults

Lindsey L Perea, Joshua P Hazelton, Nicole Fox, John P Gaughan, John Porter, Anna Goldenberg
OBJECTIVES: Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center. METHODS: A retrospective review (January 2000 to May 2016) was conducted of all pediatric (<18 years old) trauma patients who presented with a vascular injury...
October 17, 2018: Pediatric Emergency Care
Carol L Shields, Luis A Acaba-Berrocal, Evan B Selzer, Eileen L Mayro, Jennifer H Newman, Kunal Malik, R Joel Welch, Jerry A Shields
PURPOSE: To evaluate clinical features and survival outcomes of uveal metastasis based on patient age. METHODS: Retrospective analysis of all patients with uveal metastasis evaluated on the Ocular Oncology Service, Wills Eye Hospital, Philadelphia, PA, USA between February 1, 1974 and June 1, 2017. The features and outcomes were analyzed based on patient age classified as children (0-20 years), young adults (21-40 years), middle [aged] adults (41-60 years), older adults (61-80 years) and senior adults (81-100 years)...
October 16, 2018: Retina
Isis Marques Severo, Ricardo Kuchenbecker, Débora Feijó Villas Boas Vieira, Luciana Ramos Correa Pinto, Michele Elisa Weschenfelder Hervé, Amália de Fátima Lucena, Miriam de Abreu Almeida
AIM: To develop and validate a predictive model for falls in hospitalized adult clinical and surgical patients, assessing intrinsic (i.e. patient-related) and extrinsic factors (i.e. care process-related). BACKGROUND: To identify factors predictive of falls and enable appropriate management of fall risk it is necessary to understand patient and environmental factors, along with care delivery processes. DESIGN: A matched case-control study...
October 18, 2018: Journal of Advanced Nursing
Alberto Pilotto, Nicola Veronese, Julia Daragjati, Alfonso J Cruz-Jentoft, Maria Cristina Polidori, Francesco Mattace-Raso, Marc Paccalin, Eva Topinkova, Giacomo Siri, Antonio Greco, Arduino A Mangoni, Stefania Maggi, Luigi Ferrucci
Background: Multidimensional prognostic index (MPI) is useful as prognostic tool in hospitalized older patients, but our knowledge derived from retrospective studies. We therefore aimed to evaluate in a multi-center, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, re-hospitalization and use of homecare services during 12 months. Methods: This longitudinal study, carried-out between February 2015 and August 2017, included nine public hospitals in Europe and Australia...
October 17, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Lucía Miguel, Fernando Salvador, Elena Sulleiro, Adrián Sánchez-Montalvá, Daniel Molina-Morant, Isabel López, Israel Molina
Dientamoeba fragilis is an intestinal protozoan, usually considered nonpathogenic. However, in the last years, there has been an attempt to clarify its possible pathogenic role. We aim to evaluate the clinical and epidemiological characteristics of D. fragilis -infected patients. Adults with D. fragilis detection in feces who attended the Vall d'Hebron University Hospital (Barcelona, Spain) were evaluated retrospectively from April 2009 to March 2014. We classified the patients in asymptomatic, symptomatic without other causes except infection of D...
September 17, 2018: American Journal of Tropical Medicine and Hygiene
Els Devriendt, Pieter Heeren, Steffen Fieuws, Nathalie I H Wellens, Mieke Deschodt, Johan Flamaing, Marc Sabbe, Koen Milisen
BACKGROUND: International guidelines recommend adapting the classic emergency department (ED) management model to the needs of older adults in order to ameliorate post-ED outcomes among this vulnerable group. To improve the care for older ED patients and especially prevent unplanned ED readmissions, the URGENT care model was developed. METHODS: The URGENT care model is a nurse-led, comprehensive geriatric assessment based care model in the ED with geriatric follow-up after ED discharge...
October 16, 2018: BMC Geriatrics
Zhen Liang, Chen Xu, Yi Cao, Hai-Dong Kan, Ren-Jie Chen, Chun-Yan Yao, Xiao-Ling Liu, Ying Xiang, Na Wu, Long Wu, Ya-Fei Li, Ai-Ling Ji, Tong-Jian Cai
Schizophrenia is a devastating neuropsychiatric disorder with increasing concern. Limited studies have been conducted to assess the relationship between short-term exposure to ambient air pollution and schizophrenia attacks. This study aimed to investigate the associations between short-term air pollution exposure and schizophrenia outpatient visits based on a time-series study performed in China. Daily data of schizophrenia outpatient admissions and air pollution from 1 October 2010 to 31 December 2013 were collected in Xi'an, a heavily-polluted city in China...
October 3, 2018: Environmental Pollution
Kelvin Robertson, Laurence A G Marshman, David Plummer, Elena Downs
Importance: Optimal pharmacologic treatment for chronic sciatica (CS) is currently unclear. While gabapentin (GBP) and pregabalin (PGB) are both used to treat CS, equipoise exists. Nevertheless, pharmaceutical regulation authorities typically subsidize one drug over the other. This hinders interchange wherever the favored drug is either ineffective or ill-tolerated. Objective: To assess GBP vs PGB head to head for the treatment of CS. Design, Setting, and Participants: A preplanned interim analysis of a randomized, double-blind, double-dummy crossover trial of PGB vs GBP for management of CS at half the estimated final sample size was performed in a single-center, tertiary referral public hospital...
October 15, 2018: JAMA Neurology
Emily Reeve, Jennifer L Wolff, Maureen Skehan, Elizabeth A Bayliss, Sarah N Hilmer, Cynthia M Boyd
Importance: Use of harmful and/or unnecessary medications in older adults is prevalent. This can lead to avoidable harms such as adverse drug reactions, falls, hospitalization, and mortality. Primary care physicians report that patient resistance to discontinuing medication use is a significant barrier to deprescribing. Objective: To describe the attitudes of older adults toward deprescribing and to determine whether individual characteristics are associated with these attitudes...
October 15, 2018: JAMA Internal Medicine
Michael P McClincy, Drake G Lebrun, Frances A Tepolt, Young-Jo Kim, Yi-Meng Yen, Mininder S Kocher
BACKGROUND: Acetabular cartilage lesions are a known cause of poor outcomes after hip arthroscopy and are seen regularly among adolescents. However, studies identifying preoperative factors predictive of acetabular cartilage lesions have been limited to adult populations. PURPOSE: To assess clinical and radiographic predictors of acetabular cartilage lesions in a large cohort of adolescents undergoing hip arthroscopy. STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 3...
October 16, 2018: American Journal of Sports Medicine
Kyoung Yun Kim, Jung-Mi Yun
BACKGROUND/OBJECTIVE: As aging progresses, the number of patients with cognitive impairment also increases. Cognitive function is not generally correlated with diet, and there is debate over that association. Thus, the present study aimed to investigate the association between dietary intake and cognitive function among adults aged 50 years or older. SUBJECTS/METHODS: Between July 2017 and March 2018, 324 adults aged over 50 years from Gwangju Sun-Han hospital participated in a dietary survey...
October 2018: Nutrition Research and Practice
Marta Tremolada, Sabrina Bonichini, Giuseppe Basso, Marta Pillon
PURPOSE: Few studies have captured the unique ways in which cancer affects the growth and development of adolescent and young adult cancer survivors. This paper illustrates the daily life of childhood cancer survivors who are now adolescents and young adults, their post-traumatic growth and follow-up perceptions, adopting a narrative approach. METHODS: One thousand adolescent and young adult cancer survivors, mean age at diagnosis being 9.26 years old (SD = 4...
October 2018: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
David Blitzer, Jeremy L Herrmann, John W Brown
BACKGROUND: Mitral valve replacement (MVR) with a pulmonary autograft (Ross II) may be a useful technique for pediatric and young adult patients who wish to avoid anticoagulation. Our aim was to evaluate the long-term outcomes of the Ross II procedure at our institution. METHODS: Patients undergoing the Ross II procedure between June 2002 and April 2008 were included. Preoperative diagnoses included rheumatic disease (n = 5), congenital mitral valve (MV) pathology (partial atrioventricular canal defect [n = 2], complete atrioventricular canal defect [n = 1], Shone's complex [n = 1]), and myocarditis (n = 1)...
November 2018: World Journal for Pediatric & Congenital Heart Surgery
Sarah A Mbayei, Amanda Faulkner, Christine Miner, Karen Edge, Victor Cruz, Sandra A Peña, Kathy Kudish, Joan Coleman, Eva Pradhan, Stepy Thomas, Stacey Martin, Tami H Skoff
Background: The incidence of pertussis in the United States has increased in recent years. While characteristics of severe pertussis infection have been described in infants, fewer data are available in older children and adults. In this analysis, we characterize pertussis infections in hospitalized patients of all ages. Methods: Cases of pertussis with cough onset from January 1, 2011 through December 31, 2015 from 7 U.S. Emerging Infections Program Network states were reviewed...
October 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Priya Mendiratta, Jeanne Y Wei, Neeraj Dayama, Xiaocong Li
BACKGROUND: Patients with Down syndrome (DS) often survive into adulthood. Relatively little information is currently available regarding hospitalization outcomes among mature, older adults with DS. OBJECTIVE: To identify risk factors associated with hospital mortality rates and increased costs for hospitalized older adults with DS. METHODS: Data on hospitalized older adults with DS (≥65 years) were identified from the Nationwide Inpatient Sample database (6) from 2002 through 2012...
October 3, 2018: Journal of Alzheimer's Disease: JAD
Azizollah Yousefi, Shahryar Eslami, Samileh Noorbakhsh, Morteza Haghighi, Leila TaheriNia, Fahimeh Ehsanipour
BACKGROUND: High resistance to common antibiotics has become a huge global dilemma in eradicating Helicobacter Pylori infection in both children and adults. The great concern is about the resistance to different classes of antibiotics especially Clarithromycin because of its widespread use. The present survey aimed to assess the resistance rate to Clarithromycin in Helicobacter Pylori isolated in patients aged less than 15 years as compared to patients older than 15 years of age. METHODS: In this cross-sectional study, total 72 patients with upper gastrointestinal symptoms requiring diagnostic endoscopy referred to Rasoul-e-Akram Hospital in Tehran during one year (August 2015 to August 2016)...
October 12, 2018: Infectious Disorders Drug Targets
Kathleen Kearney, Charles Maynard, Bryn Smith, Thomas D Rea, Alexis Beatty, James M McCabe
AIMS: Out of Hospital Cardiac Arrest (OHCA) is frequently attributed to coronary artery disease, thus guidelines recommend coronary angiography (CAG) for survivors of OHCA. However, the real-world application of these guidelines is unknown, and we sought to evaluate CAG practices in the contemporary OHCA population. METHODS: The Clinical Outcomes Assessment Program (COAP), a Washington State public reporting system, and the Cardiac Arrest Registry to Enhance Survival (CARES), a national registry of OHCA, were matched to characterize OHCA presentations between 2014 and 2015...
October 11, 2018: Resuscitation
Evan C Carlos, Chloe E Peters, Daniel A Wollin, Brenton B Winship, Leah G Davis, Jingqiu Li, Charles D Scales, Samuel H Eaton, Glenn M Preminger, Michael E Lipkin
PURPOSE: Emergency department(ED) visits after ureteroscopy(URS) are costly and inconvenient. To better understand those at risk, we aim to identify patient demographic, medical and surgical factors associated with 30-day ED presentation following URS for urolithiasis with particular attention paid to those with a history of a psychiatric diagnosis(PD). MATERIALS AND METHODS: We retrospectively reviewed 1576 cases on 1395 adults who underwent stone-related URS over 3 years at two hospitals...
October 11, 2018: Journal of Urology
Mariana Mirabel, Thibaud Damy, Erwan Donal, Olivier Huttin, Fabien Labombarda, Jean-Christophe Eicher, Claudio Cervino, Marianna Laurito, Lucile Offredo, Muriel Tafflet, Xavier Jouven, Geltrude Giura, Michel Desnos, Xavier Jeunemaître, Jean-Philippe Empana, Philippe Charron, Gilbert Habib, Patricia Réant, Albert Hagège
BACKGROUND: Our knowledge of hypertrophic cardiomyopathy (HCM) mainly originates from quarternary centres. The objective is to assess the current management of HCM patients in a large multicentre French register according to the level of expertise. METHODS AND RESULTS: A total of 1431 HCM patients were recruited across 26 (11 expert and 15 non-expert) centres in REMY, a prospective hospital-based register of adult HCM patients. A sarcomeric origin was suspected in 1284 (89...
September 28, 2018: International Journal of Cardiology
Nirma Khatri Vadlamudi, Anna Chen, Fawziah Marra
BACKGROUND: A notable reduction of pneumococcal disease burden among adults was observed after introduction of 7 valent- pneumococcal conjugate vaccine in childhood immunization programs. In 2010, 13 valent-pneumococcal conjugate vaccine (PCV13) replaced PCV7 in many jurisdictions; a comparative assessment of PCV13's impact has not yet been performed. OBJECTIVE: To summarize available data and assess the change in the incidence of invasive pneumococcal disease (IPD) in adults after the introduction of PCV13 in childhood immunization programs...
October 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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