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Geriatric review

Hiromi Sasaki, Satoshi Nagano, Noboru Taniguchi, Takao Setoguchi
Malignant soft-tissue sarcoma resection is associated with a relatively high incidence of surgical site infection (SSI). The known risk factors for SSI following soft-tissue sarcoma resection include tumor size and location, prolonged surgery, and massive blood loss. The geriatric nutritional risk index (GNRI) was used as a tool to help predict the occurrence of SSI after major surgery. We investigated the utility of the GNRI as a predictor of SSI following soft-tissue sarcoma resection. We retrospectively reviewed 152 patients who underwent surgical resection of soft-tissue sarcoma in our institute, and found that the incidence of SSI was 18...
December 3, 2018: Nutrients
Aida Wen, Lorrie Wong, Carolyn Ma, Robin Arndt, Alan R Katz, Karol Richardson, Melodee Deutsch, Kamal Masaki
Interprofessional collaboration is an essential skill to optimize the care of older adults with complex problems. We successfully developed and evaluated an interprofessional teamwork simulation exercise for medical, nursing, pharmacy, and social work students. Pharmacy students participated via video conferencing. Before the simulation, students watched a teamwork video and reviewed the patient case. Following an icebreaker exercise, interdisciplinary faculty facilitated a discussion highlighting effective teamwork strategies...
December 4, 2018: Gerontology & Geriatrics Education
Qiaozhi Hu, Bin Wu, Mei Zhan, Weiguo Jia, Yimei Huang, Ting Xu
OBJECTIVES: The purpose of this study was to describe the level, preventability and categories of adverse events (AEs) in Chinese geriatric patients identified by medical record review using the Global Trigger Tool. The applicability of the GTT was also assessed to explore possible modifications for trigger tools. METHODS: The study was conducted at a 4300-bed tertiary teaching hospital. Twenty randomly-selected medical records for patients over 60 were reviewed every 2 weeks from January 1 2015 to December 31st, 2015...
December 3, 2018: Journal of Evidence-based Medicine
Teppei Okamoto, Shingo Hatakeyama, Shintaro Narita, Masahiro Takahashi, Toshihiko Sakurai, Sadafumi Kawamura, Senji Hoshi, Masanori Ishida, Toshiaki Kawaguchi, Shigeto Ishidoya, Jiro Shimoda, Hiromi Sato, Koji Mitsuzuka, Tatsuo Tochigi, Norihiko Tsuchiya, Yoichi Arai, Tomonori Habuchi, Chikara Ohyama
PURPOSE: To investigate the association between the Geriatric Nutritional Risk Index (GNRI) and prognosis of patients with metastatic hormone-naïve prostate cancer (mHNPC) and to design the optimal risk score predicting for prognosis. METHODS: We retrospectively reviewed data from the Michinoku Japan Urological Cancer Study Group database, containing information about 656 patients with mHNPC who initially received androgen-deprivation therapy between 2005 and 2017...
December 4, 2018: World Journal of Urology
Simon T Schaefer, Stephan Koenigsperger, Cynthia Olotu, Thomas Saller
PURPOSE OF REVIEW: Neurocognitive dysfunction after surgery is highly relevant in the elderly. The multifactorial manner of this syndrome has made it hard to define an ideal biomarker to predict individual risk and assess diagnosis and severity of delirium [postoperative delirium (POD)] and subsequent postoperative cognitive decline (POCD). This review summarizes recent literature on blood biomarkers for POD/POCD. RECENT FINDINGS: Markers for delirium have been searched for in the cerebrospinal fluid to examine the pathologic cascade...
November 29, 2018: Current Opinion in Anaesthesiology
Weihong Zhang, Lee-Fay Low, Josephine Diana Gwynn, Lindy Clemson
OBJECTIVES: To review intervention programs that measure gait to investigate what features of the intervention may contribute to improving gait in older adults with cognitive impairment or dementia. DESIGN: Systematic review using Medline, Cinahl, Scopus, PsychInfo, Amed, Embase, Web of Science, and PubMed for original research published in English between January 1, 2000, and July 23, 2018, to identify interventional controlled trials. Narrative synthesis was undertaken...
December 2, 2018: Journal of the American Geriatrics Society
Laura C Michaelis
Given the recent approvals of new agents for acute myeloid leukemia (AML), a clinical trial pipeline stocked with novel therapies, and the rapid integration of imaginative approaches in diseases like acute lymphocytic leukemia and chronic lymphocytic leukemia, it is reasonable to ask whether treatment of AML might finally depart from the classical cytotoxic induction therapy that has been employed since the 1970s. However, for better or worse, in 2018, cytotoxic induction regimens remain the standard of care for most patients...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Alejandra Gullón, Demetrio Sánchez Fuentes, Esteban López-de-Sá, Julio Martí-Almor, Gonzalo Barón-Esquivias, Jesús Jiménez López, María Del Mar Contreras Muruaga, Carmen Suárez Fernández
The present article provides an update on anticoagulant treatment in patients with atrial fibrillation in distinct clinical scenarios requiring particular considerations, such as ischaemic heart disease, electrical cardioversion, pulmonary vein ablation, the presence of valvular disease with or without prosthetic valves, and renal insufficiency, as well as old age and frailty. In patients with non-valvular atrial fibrillation, the presence of renal insufficiency increases both thrombotic and haemorrhagic risk...
June 2018: Medicina Clínica
Rahman G Barry, Thao T Wolbert, Farid B Mozaffari, Peter D Ray, Errington C Thompson, Todd W Gress, David A Denning
BACKGROUND: Blunt trauma in the geriatric population is fraught with poor outcomes, with injury severity and comorbidities impacting morbidity and mortality. METHODS: We retrospectively reviewed 2172 patients aged ≥65 y who fell, requiring hospital admission between January 2012 and December 2016. There were 403 patients in the surgical arm (SA) and 1769 patients in the medical arm (MA). Ground-level falls were the only mechanism of injury included. We excluded all ICU admissions and deaths within 24 h...
January 2019: Journal of Surgical Research
Monica Zolezzi, Cheryl A Sadowski, Nermin Al-Hasan, Omnia Gad Alla
INTRODUCTION: Older adults constitute the largest population admitted to hospitals due to chronic diseases, which requires appropriate prescribing of medications and comprehensive pharmaceutical care. The views and perspectives of students and educators can inform curriculum review in geriatric education in pharmacy schools. METHODS: A cross sectional online survey containing 34 questions covering the areas of curriculum content and perceived needs for geriatric education was administered to students, faculty members, and preceptors...
September 2018: Currents in Pharmacy Teaching & Learning
Rainer Wirth, Rainer Dziewas
PURPOSE OF REVIEW: The review summarizes current knowledge and recent findings about how to practically apply medication in patients with dysphagia and how swallowing function may be positively or negatively affected by drugs. RECENT FINDINGS: Oropharyngeal dysphagia is a major health problem in older persons and was recently classified as a geriatric syndrome. Although the knowledge about an effective diagnostic approach increased during the last years, comparatively little is known about how to effectively manage and treat dysphagia and hardly anything is implemented in clinical routine...
January 2019: Current Opinion in Clinical Nutrition and Metabolic Care
Nicolò Matteo Luca Battisti, Nienke De Glas, Mina S Sedrak, Kah Poh Loh, Gabor Liposits, Enrique Soto-Perez-de-Celis, Jessica L Krok-Schoen, Ines B Menjak, Alistair Ring
The current standard of care for the management of estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer has been redefined by the introduction of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors. Although adults aged 65 years and older account for the majority of patients with breast cancer, limited data are available about the age-specific dosing, tolerability, and benefit of CDK4/6 inhibitors in this growing population. Older adults are under-represented in clinical trials and as a result, clinicians are forced to extrapolate from findings in younger and healthier patients when making treatment decisions for older patients...
2018: Therapeutic Advances in Medical Oncology
Bertrand Guidet, Helene Vallet, Jacques Boddaert, Dylan W de Lange, Alessandro Morandi, Guillaume Leblanc, Antonio Artigas, Hans Flaatten
BACKGROUND: There is currently no international recommendation for the admission or treatment of the critically ill older patients over 80 years of age in the intensive care unit (ICU), and there is no valid prognostic severity score that includes specific geriatric assessments. MAIN BODY: In this review, we report recent literature focusing on older critically ill patients in order to help physicians in the multiple-step decision-making process. It is unclear under what conditions older patients may benefit from ICU admission...
November 26, 2018: Annals of Intensive Care
Naoki Saji, Takashi Sakurai, Kengo Ito, Hidekazu Tomimoto, Kazuo Kitagawa, Kaori Miwa, Yuji Tanaka, Koichi Kozaki, Kazuomi Kario, Masato Eto, Keisuke Suzuki, Atsuya Shimizu, Shumpei Niida, Akihiro Hirakawa, Kenji Toba
INTRODUCTION: Non-valvular atrial fibrillation (NVAF) is known as a robust risk factor for stroke. Recent reports have suggested a risk of dementia with NVAF, but much remains unknown regarding the relationship between this mechanism and the potential protective effects of novel anticoagulants (direct oral anticoagulants (DOACs), or non-vitamin K oral anticoagulants). METHODS AND ANALYSIS: This study, the strategy to obtain warfarin or DOAC's benefit by evaluating registry, is an investigator-initiated, multicentre, prospective, observational, longitudinal cohort study comparing the effects of warfarin therapy and DOACs on cerebrovascular diseases and cognitive impairment over an estimated duration of 36 months...
November 25, 2018: BMJ Open
Caroline Masse-Sibille, Bennabi Djamila, Giustiniani Julie, Haffen Emmanuel, Vandel Pierre, Chopard Gilles
BACKGROUND: Geriatric depression is a heterogeneous disorder that increases morbidity and mortality in a population that is already vulnerable. Predicting response and remission to antidepressants could help clinicians to optimize the management of antidepressants and reduce the consequences of depression. METHOD: The aim of this article is to present results of a systematic review of the literature on predictive factors related to antidepressant response and remission in older adults with depression...
November 2018: Journal of Geriatric Psychiatry and Neurology
Elizabeth Hogan, Isabel Almira-Suarez, Siyuan Li, Sean P Collins, Walter C Jean
BACKGROUND: Prostate Cancer is the most common cancer among American men, with an incidence of approximately 233,000 cases per year.Intracranial metastases are rare and specifically, metastasis to the pineal gland has only been reported in 2 post mortem cases in the literature. CASE DESCRIPTION: We present the first documented case of confirmed prostate cancer metastasis to the pineal gland in a living patient. The patient underwent an endoscopic third ventriculostomy and pineal lesion biopsy with complete resolution of his hydrocephalus and presenting symptoms...
November 23, 2018: World Neurosurgery
Bernardo Cedeno-Veloz, Pedro López-Dóriga Bonnardeauxa, Gustavo Duque
Osteosarcopenia is a phenotype resulting from the combination of sarcopenia and low bone mineral density. Based on the relationship between bone and muscle, this phenotype is associated with a higher risk of falls, fractures, dependence, and health care costs than its individual components. Given its characteristics, it can be considered as a new geriatric syndrome. Therefore, understanding its pathophysiology and diagnosis, as well as its non-pharmacological and pharmacological management is a task of great importance...
November 21, 2018: Revista Española de Geriatría y Gerontología
Kathleen C Woulfe, Danielle R Bruns
Heart failure (HF) is a significant public health problem and a disease with high 5-year mortality. Although age is the primary risk factor for development of HF, it is a disease which impacts patients of all ages. Historically, HF has been studied as a one-size fits all strategy- with the majority of both clinical and basic science investigations employing adult male subjects or adult male pre-clinical animal models. We postulate that inclusion of biological variables in HF studies is necessary to improve our understanding of mechanisms of HF and improve outcomes...
November 17, 2018: Journal of Molecular and Cellular Cardiology
Shiney Franz, Jürgen Muser, Ulrike Thielhorn, Claus W Wallesch, Johann Behrens
BACKGROUND: Neurological early rehabilitation aims at regaining cooperativity and acquiring rehabilitation capability with brain-injured patients, most of whom are transferred from Intensive Care Units, most of whom still require intensive care and suffer from disorders of consciousness. In neurological early rehabilitation, therapeutic nursing is an integral part of the therapeutic team. Other than the specialized therapists, nurses are present on the ward 24/7, which gives them a closer perspective on the patient...
November 20, 2018: Disability and Rehabilitation
Ayesha R Sheikh, Hassan Yameen, Kevan Hartshorn
PURPOSE OF REVIEW: Rectal cancer is predominantly a disease of older adults but current guidelines do not incorporate the associated specific challenges leading to wide variation in the delivery of cancer care to this subset of population. Here, we will review the current data available regarding the management of rectal cancer in older adults. RECENT FINDINGS: The greatest challenge arises in the management of stage II/III disease as it involves tri-modality treatment that can be harder to tolerate by frail older patients...
November 20, 2018: Current Oncology Reports
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