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problems with the elderly

Arritxu Etxeberria, Josune Iribar, Rafael Rotaeche, Kalliopi Vrotsou, Iosu Barral
BACKGROUND AND OBJECTIVE: Several interventions have been shown to reduce polypharmacy and potentially inappropriate prescription (PIP). The objective of the study was to evaluate the number of drugs and PIP before and after an educational intervention with the Primary Care physician (PCP), with electronic identification of PIP and structured medication review, in elderly patients with excessive polypharmacy (≥10 drugs). MATERIAL AND METHODS: A before-after intervention study was conducted in the Gipuzkoa district of Osakidetza (Basque Country Health System), in a random sample of patients older than 80 years taking ≥ 10 drugs, and whose PCP attended training sessions...
August 7, 2018: Revista Española de Geriatría y Gerontología
Paola C Sacco, Paolo Maione, Giovanni Palazzolo, Cesare Gridelli
Lung cancer is predominantly a disease that affects the elderly; about 30-40% of lung cancers are diagnosed in patients aged 70 or more. The increasing number of elderly patients over the next decades is generating a new social and health problem; despite that, these patients are under-represented in clinical trials and under-treated in clinical practice. Areas covered: The main difficulty in treating elderly patients is to maximize the therapy benefits while minimizing the treatment risk. Elderly patients show a vulnerable clinical profile due to the higher prevalence of comorbid disease, higher polypharmacy interactions and aged organ dysfunction that increase the risk of mortality and toxicity with cancer treatments compared to younger patients...
August 9, 2018: Expert Review of Respiratory Medicine
Ruth Prieto, Xavier Santander, José Manuel Naranjo, Esperanza Marín, Cesáreo Corbacho
BACKGROUND: Dumbbell-shaped schwannomas involving the spinal canal, the intervertebral foramen and the thoracic cavity are rare lesions. Their surgical treatment represents a challenge and there is no consensus regarding their ideal management. Two major surgical routes have been used: a combined laminectomy and open thoracotomy, or a posterolateral extrapleural approach with wide bone removal. This report describes a relatively easy surgical strategy, the combined laminectomy and thoracoscopy, which allows a safe resection under an adequate view with low risk of spinal instability, pain or respiratory problems...
August 6, 2018: World Neurosurgery
Fernanda Rossi Paolillo, Vicente Silva Mattos, André Orlandi de Oliveira, Francisco Eduardo Gontijo Guimarães, Vanderlei Salvador Bagnato, Jarbas Caiado de Castro Neto
Diabetes is a complex metabolic disease and has chronic complications. It has been considered a serious public health problem. The aim of the current study was to evaluate skin glycated proteins through fluorescence and Raman techniques. One hundred subjects were invited to participate in the study. Six volunteers did not attend due to exclusion criteria or a change of mind about participating. Therefore, ninety four volunteers were grouped according to age range (20 to 80 years), health condition (non-diabetic, with insulin resistance (IR) and/or diabetic) and Fitzpatrick skin type (I to VI)...
August 9, 2018: Journal of Biophotonics
I-Hsuan Lin, Junn-Liang Chang, Kate Hua, Wan-Chen Huang, Ming-Ta Hsu, Yi-Fan Chen
BACKGROUND: Aging leads to decreased skeletal muscle function in mammals and is associated with a progressive loss of muscle mass, quality and strength. Age-related muscle loss (sarcopenia) is an important health problem associated with the aged population. RESULTS: We investigated the alteration of genome-wide transcription in mouse skeletal muscle tissue (rectus femoris muscle) during aging using a high-throughput sequencing technique. Analysis revealed significant transcriptional changes between skeletal muscles of mice at 3 (young group) and 24 (old group) months of age...
August 8, 2018: BMC Genetics
Girliani Silva de Sousa, Jaqueline Galdino Albuquerque Perrelli, Everton Sougey Botelho
OBJECTIVE: To analyze the specialized literature regarding the risk factors in nursing diagnosis for suicide risks in elderly. METHOD: This is an integrative literature review carried out during June 2015 in the following databases with no time limit: MEDLINE, PsycINFO and CINAHL. RESULTS: A total of 80 full papers were analyzed. It was suggested the inclusion of 23 risk factors in NANDA-I taxonomy: apathy; unrest; low self esteem; carelessness with medication; Inability to ask for help; Inability to express feelings; suicidal plan; rigidity; functional disability; visual problems; sadness; hostility; anxiety; failure; frustration; unhappiness; dishonor; frequent visits to a physician with unclear symptoms; social deprivation; social devaluation; psychological violence; Interfamilial violence; and financial violence...
August 2, 2018: Revista Gaúcha de Enfermagem
Sandra C Fuchs, Erno Harzheim, Cirano Iochpe, Caroline N de David, Marcelo R Gonçalves, Guilhermo P Sesin, Cassio M Costa, Leila B Moreira, Flavio D Fuchs
BACKGROUND: Hypertension is a growing problem worldwide, markedly in low- and middle-income countries, where the rate of control slightly decreased. The overall prevalence of hypertension in Brazil is 28.7% among adult individuals and 68.9% in the population aged 60 years and older, and less than a third of patients have controlled blood pressure (BP). The use of technologies-mobile phones and the internet-to implement interventions to reduce blood pressure can minimize costs and diminish cardiovascular risk...
August 7, 2018: JMIR Research Protocols
Cecilia Lenander, Åsa Bondesson, Nina Viberg, Anders Beckman, Patrik Midlöv
BACKGROUND: Drug use among the elderly population is generally extensive and the use of potentially inappropriate medications (PIMs) is common, which increases the risk for drug-related problems (DRP). Medication reviews are one method to improve drug therapy by identifying, preventing and solving DRPs. The aim of this study was to evaluate the effect of medication reviews on total drug use and potentially inappropriate drug use in elderly patients, as well as describe the occurrence and types of drug-related problems...
August 7, 2018: BMC Health Services Research
Shinji Takahashi, Masatoshi Hoshino, Hiroyuki Yasuda, Hidetomi Terai, Kazunori Hayashi, Tadao Tsujio, Hiroshi Kono, Akinobu Suzuki, Koji Tamai, Shoichiro Ohyama, Hiromitsu Toyoda, Sho Dohzono, Fumiaki Kanematsu, Yusuke Hori, Hiroaki Nakamura
STUDY DESIGN: Propensity score matching study OBJECTIVE.: To assess the cost effectiveness of balloon kyphoplasty (BKP) in Japan. SUMMARY OF BACKGROUND DATA: Osteoporotic vertebral fracture (OVF) is a common disease in elderly people. In Japan, the incidence of painful OVF in 2008 was estimated as 880,000, and approximately 40% of patients with painful OVF are hospitalized due to the severity of pain. Japan is the front runner among super-aged societies and rising health care costs are an economic problem...
August 6, 2018: Spine
Qinqiuzi Yi, Junko Honda, Naohiro Hohashi
BACKGROUND: The older adult population is increasing in number, and elder abuse is expected to become a more pressing problem. Developing tools to assess the presence and severity of elder abuse is important to both effectively prevent this abuse and provide increased support for families. PURPOSE: This study was intended to test the validity of an assessment tool for domestic elder abuse (ATDEA). The items that constitute this tool were derived from a literature review...
August 7, 2018: Journal of Nursing Research: JNR
Ulrich Jaehde, Petra Thürmann
Due to demographic change, the number of elderly patients in need of long-term care is continuously increasing. Residents in nursing homes often suffer from various chronic diseases leading to the prescription of a plethora of drugs and a high risk for adverse drug reactions (ADR). Particularly, CNS-active drugs are critical in this context. Moreover, the medication process in nursing homes is complex with numerous interfaces and error sources. Therefore, medication safety for long-term care residents is regarded as a multiprofessional challenge...
August 6, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Sandeep Mahapatra, Pinjala Ramakrishna, Bhumika Gupta, Arumalla Anusha, Muneer Ahmad Para
Background & objectives: Chronic venous insufficiency (CVI) is a common clinical problem among obese patients. This study was conducted to evaluate the impact of body mass index (BMI) and associated morbidities such as diabetes, hypertension and hypothyroidism on venous disease clinical scores as per Clinical, Etiological, Anatomical, Pathological (CEAP) classification. Methods: In this study, adult patients with BMI more than 30 kg/m2 with signs of CVI were evaluated clinically and by using Duplex ultrasonography of venous system...
May 2018: Indian Journal of Medical Research
Tong Lin, Shengqi Dong, Jie Zhen, Xiaochen Huang, Linhong Yuan
OBJECTIVE: To evaluate the diet quality of the Chinese elderly using adjusted Chinese Diet Balance Index( DBI-07) and to explore the association between dietary patterns and blood glucose and lipid with the aiming to provide scientific basis and theoretical support for nutrition education intervention. METHODS: A total of 1158 participants aged 50-90 involved in this cross-sectional study. The subjects were randomly recruited from Nanyuan Community and Wulituo Community by posting small advertisements in 2013-2015...
May 2018: Wei Sheng Yan Jiu, Journal of Hygiene Research
Ciro Manzo, Jordi Serra-Mestres, Alberto Castagna, Marco Isetta
Background: Since the introduction of glucocorticoids (GCs) in the physician's pharmacological arsenal, it has been known that they are a cause of behavioral or psychiatric adverse events (BPAE), as well as of cognitive problems. To the best of our knowledge, the relationship between these adverse events and GCs in older persons has never been evaluated, except through case-reports or series with few cases. In this paper, a review of the literature regarding BPAEs and cognitive disorders in older people treated with CSs is undertaken...
August 1, 2018: Medicines (Basel, Switzerland)
Qian Chen, Ju-Hong Guo, Xiao-Feng Xu, Yan Zhou, Yin Zhang, Xiu-Ying Hu
BACKGROUND: While many studies have examined multidisciplinary interventions for swallowing disorder, most have focused on acute stroke patients. It is essential to confirm the efficacy of multidisciplinary interventions for all causes of swallowing disorder. PURPOSE: To investigate the efficacy of a nurse-led, multi-disciplinary intervention for hospitalized elderly patients with swallowing disorder. METHODS: One hundred and forty-five elderly patients with swallowing problems from a well-respected affiliate hospital of a university were studied...
August 2018: Hu Li za Zhi the Journal of Nursing
Ching-Ching Lin, Sue-Hsien Chen, Li-Yuan Huang
BACKGROUND: Metabolic syndrome, a widespread condition in Taiwan, increases the risks of cardiovascular diseases. Cardiovascular disease is the second leading cause of death in Taiwan after cancer. Thus, this health problem is a priority issue of concern. PURPOSE: To study the effects of active intervention of interdisciplinary health education on the prevalence of metabolic syndrome in community residents. METHODS: This longitudinal study was conducted from 2014 to 2015 on 661 participants who were all over 30 years old and living in four towns in northern Taiwan...
August 2018: Hu Li za Zhi the Journal of Nursing
Mi-Ra Choi, Jung-Min Shin, Young-Ah Shin, Yun-Hee Chang, Min-Youl Chang, Cho-Ah Lim, Kyung-Cheol Sohn, Young-Joon Seo, Chang-Deok Kim, Jeung-Hoon Lee, Young Lee
Background: Skin hydration is a common problem both in elderly and young people as dry skin may cause irritation, dermatological disorders, and wrinkles. While both genetic and environmental factors seem to influence skin hydration, thorough genetic studies on skin hydration have not yet been conducted. Objective: We used a genome-wide association study (GWAS) to explore the genetic elements underlying skin hydration by regulating epidermal differentiation and skin barrier function...
August 2018: Annals of Dermatology
Michael Bento Schmid, Lucie Kopfstein
We describe a dramatic clinical presentation of extramedullary multiple myeloma (MM) in an elderly patient with known monoclonal gammopathy of unknown significance (MGUS). Gastrointestinal symptoms and a gastric mass on imaging studies suggested an advanced solid gastric malignancy. Pathological workup of gastric biopsies first suspected a lymphoma, a second opinion finally confirmed an extramedullary MM. Treatment with bortezomib, cyclophosphamide and dexamethasone induced rapid relief of symptoms and normalisation of renal function as well as serum MM markers...
July 30, 2018: BMJ Case Reports
Dirk Heider, Herbert Matschinger, Andreas D Meid, Renate Quinzler, Jürgen-Bernhard Adler, Christian Günster, Walter E Haefeli, Hans-Helmut König
BACKGROUND: In the growing population of the elderly, drug-related problems are considered an important health care safety issue. One aspect of this is the prescription of potentially inappropriate medication (PIM) which is considered to increase health care costs. OBJECTIVE: Using data from the Health Economics of Potentially Inappropriate Medication (HEPIME) study, we aimed to analyze how the number of prescribed substances moderates the association of PIM use as defined by the German PRISCUS list and health care costs applying a longitudinal perspective...
2018: PloS One
Jing Zhu, Lingzhong Xu, Long Sun, Jiajia Li, Wenzhe Qin, Gan Ding, Qian Wang, Jiao Zhang, Su Xie, Zihang Yu
Objective: Suicide is a major public health and social problem in contemporary societies. Previous studies showed that the older the seniors were, the more likely it was that they would experience disability, chronic disease, or both. The objective of this study was to examine the joint effects of chronic disease and physical disability on suicide ideation while controlling for psychological distress among the rural elderly living in Shandong Province, China. Method : A total of 5514 rural elderly individuals (60+) living in Shandong Province, China were included in this study...
July 28, 2018: International Journal of Environmental Research and Public Health
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