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https://www.readbyqxmd.com/read/29341526/-the-internal-medicine-articles-that-struck-us-the-most-in-2017
#1
Vanessa Kraege, Evrim Jaccard, Alain Kenfak, Elisabeth Stamm, Fanny Blondet, Grégoire Humair, Plamena Tasheva, Oriane Aebischer, Sabine Giroud, Jonathan Tschopp, Claudio Sartori
2017 has continued to bring important progress in all areas of internal medicine, impacting our daily practice. From bedside screening for beta-lactam allergies, to statins as primary prevention in the elderly, SGLT2 inhibitors in heart failure, azithromycin in severe asthmatics and tofacitinib in ulcero-haemorrhagic recto-colitis, internal medicine journals are full of novelties. Every year, the chief residents of the CHUV internal medicine ward meet up to share their readings: here is their selection of eleven articles, chosen, summarized and commented for you...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341172/statin-use-and-the-risk-of-cardiovascular-implantable-electronic-device-infection-a-cohort-study-in-a-veteran-population
#2
Talal Alzahrani, Angelike P Liappis, Larry M Baddour, Pamela E Karasik
BACKGROUND: The rate of cardiovascular implantable electronic device infection (CIEDI) has increased, despite the use of perioperative antibiotics at the time of device placement or revision. This is due, in part, to the presence of multiple comorbid conditions in an elderly population, in general, who require CIED. Statins may have an antibacterial effect, although there is currently no evidence that the likelihood of CIEDI has been impacted by statin use. METHODS: A retrospective cohort study was performed to assess whether statins are associated with a reduced risk of CIEDI...
January 17, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29340718/drug-treatment-of-heart-failure-in-the-elderly
#3
REVIEW
D Berliner, J Bauersachs
The prevalence of heart failure increases with age. Changes in the age distribution and growing life expectancy will lead to a further rise. However, data concerning drug treatment of heart failure especially in the elderly are scarce. Subgroup analyses of the heart failure trials suggest that drug therapy in older patients should follow the recommendations in the current guidelines. In doing so, several common comorbidities in these patients (e. g., impaired renal function) have to be considered and may have an influence on the therapy (e...
January 16, 2018: Herz
https://www.readbyqxmd.com/read/29337859/effects-of-pharmacists-interventions-on-inappropriate-drug-use-and-drug-related-readmissions-in-people-with-dementia-a-secondary-analysis-of-a-randomized-controlled-trial
#4
Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jörn Schneede, Hugo Lövheim
Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug-drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists' interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions...
January 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29334922/relative-contribution-of-various-chronic-diseases-and-multi-morbidity-to-potential-disability-among-dutch-elderly
#5
Riaan Botes, Karin M Vermeulen, Janine Correia, Erik Buskens, Fanny Janssen
BACKGROUND: The amount of time spent living with disease greatly influences elderly people's wellbeing, disability and healthcare costs, but differs by disease, age and sex. METHODS: We assessed how various single and combined diseases differentially affect life years spent living with disease in Dutch elderly men and women (65+) over their remaining life course. Multistate life table calculations were applied to age and sex-specific disease prevalence, incidence and death rates for the Netherlands in 2007...
January 15, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29333564/is-123i-metaiodobenzylguanidine-heart-to-mediastinum-ratio-dependent-on-age-from-japanese-society-of-nuclear-medicine-normal-database
#6
Kenichi Nakajima, Koichi Okuda, Shinro Matsuo, Hiroshi Wakabayashi, Seigo Kinuya
BACKGROUND: Heart-to-mediastinum ratios (HMRs) of 123I-metaiodobenzylguanidine (MIBG) have usually been applied to prognostic evaluations of heart failure and Lewy body disease. However, whether these ratios depend on patient age has not yet been clarified using normal databases. METHODS: We analyzed 62 patients (average age 57 ± 19 years, male 45%) derived from a normal database of the Japanese Society of Nuclear Medicine working group. The HMR was calculated from early (15 min) and delayed (3-4 h) anterior planar 123I-MIBG images...
January 15, 2018: Annals of Nuclear Medicine
https://www.readbyqxmd.com/read/29331275/low-level-cadmium-exposure-and-cardiovascular-outcomes-in-elderly-australian-women-a-cohort-study
#7
Kane E Deering, Anna C Callan, Richard L Prince, Wai H Lim, Peter L Thompson, Joshua R Lewis, Andrea L Hinwood, Amanda Devine
BACKGROUND: Cadmium has been associated with increased risk of cardiovascular disease (CVD) in observational studies, however there has been a limited focus on this relationship in women. OBJECTIVES: This study investigated the association of urinary cadmium (UCd) concentrations with CVD outcomes and all-cause mortality in elderly Western Australian (WA) women. METHODS: UCd excretion was measured at baseline in 1359 women, mean age 75.2 ± 2...
December 26, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/29330813/characteristics-of-elderly-patients-initiating-sitagliptin-or-non-dpp-4-inhibitor-oral-antihyperglycemic-agents-analysis-of-a-cross-sectional-us-claims-database
#8
Tongtong Wang, Ann Marie McNeill, Yong Chen, Edward A O'Neill, Samuel S Engel
INTRODUCTION: Previous analyses concluded that patients initiating treatment with sitagliptin are older and have more comorbidities than patients initiating treatment with other oral antihyperglycemic agents (OAHAs). However, these studies focused on the general population or subjects ≤ 65 years of age. We sought to compare differences in baseline characteristics of elderly patients (≥ 65 years of age) with T2DM initiating sitagliptin vs. non-DPP-4 inhibitor (non-DPP-4i) OAHA in the MarketScan® Medicare Supplemental Database...
January 12, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29327942/efficient-selective-screening-for-heart-failure-in-elderly-men-and-women-from-the-community-a-diagnostic-individual-participant-data-meta-analysis
#9
Rogier F Kievit, Aisha Gohar, Arno W Hoes, Michiel L Bots, Evelien Es van Riet, Yvonne van Mourik, Loes Cm Bertens, Leandra Jm Boonman-de Winter, Hester M den Ruijter, Frans H Rutten
Background Prevalence of undetected heart failure in older individuals is high in the community, with patients being at increased risk of morbidity and mortality due to the chronic and progressive nature of this complex syndrome. An essential, yet currently unavailable, strategy to pre-select candidates eligible for echocardiography to confirm or exclude heart failure would identify patients earlier, enable targeted interventions and prevent disease progression. The aim of this study was therefore to develop and validate such a model that can be implemented clinically...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29321797/prediction-model-of-in-hospital-mortality-in-elderly-patients-with-acute-heart-failure-based-on-retrospective-study
#10
Qian Jia, Yu-Rong Wang, Ping He, Xue-Liang Huang, Wei Yan, Yang Mu, Kun-Lun He, Ya-Ping Tian
Objectives: The aim of this study was to develop a clinical risk model that is predictive of in-hospital mortality in elderly patients hospitalized with acute heart failure (AHF). Methods: 2486 patients who were 60 years and older from intensive care units of Cardiology Department in the hospital were analyzed. Independent risk factors for in-hospital mortality were obtained by binary logistic regression and then used to establish the risk prediction score system (RPSS)...
November 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29320602/when-metformin-is-not-enough-pros-and-cons-of-sglt2-and-dpp-4-inhibitors-as-a-second-line-therapy
#11
REVIEW
Angelo Avogaro, Elías Delgado, Ildiko Lingvay
The newer oral therapies for type 2 diabetes (T2DM); dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter 2 (SGLT2) inhibitors have advantages over older agents. DPP-4 inhibitors are weight neutral, and have few adverse effects. SGLT2 inhibitors have additional benefits; weight loss, blood pressure reduction, cardiovascular risk reduction, and renoprotective effects. SGLT2 inhibitors, have increased risk of urogenital infections and possible risk of "euglycaemic" diabetic ketoacidosis...
January 10, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29317979/a-case-of-multifaceted-assessment-in-an-elderly-patient-with-acute-decompensated-heart-failure
#12
Hideto Sako, Midori Miyazaki, Yasunori Suematsu, Rie Koyoshi, Yuhei Shiga, Takashi Kuwano, Ken Kitajima, Atsushi Iwata, Katsura Yorinaga, Kanta Fujimi, Shin-Ichiro Miura
Heart failure (HF) is a common health problem worldwide, including in Japan. Unfortunately, patient outcomes remain poor, with a 5-year survival rate of approximately 50%. Therefore, we need to assess the precise conditions, including cardiac function, in patients with HF, particularly in the elderly. We performed a multifaceted assessment in an elderly patient with HF on admission and at discharge using eight different evaluations (the mean life expectancy using the Seattle Heart Failure Model (SHFM), the severity of dementia, nutrition, medication adherence, biomarker (the level of brain natriuretic peptide in blood), sociality, performance and comorbidity)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29316267/elderly-patients-with-suspected-chronic-digoxin-toxicity-a-comparison-of-clinical-characteristics-of-patients-receiving-and-not-receiving-digoxin-fab
#13
Hooman Arbabian, Hwee Min Lee, Andis Graudins
OBJECTIVE: The aim of the present study was to compare clinical features of patients with elevated serum digoxin concentrations who were treated with digoxin-Fab with those where the immunotherapy was not given by a tertiary hospital toxicology service. METHODS: This was a retrospective series of patients with supratherapeutic serum digoxin concentrations referred to the toxicology service from August 2013 to October 2015. Data collected included demographics, presenting complaint, digoxin dose, other medications taken, serum digoxin, potassium and creatinine concentration on presentation and initial and post-digoxin-Fab heart rate...
January 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29316158/reduced-stroke-distance-of-the-left-ventricular-outflow-tract-is-independently-associated-with-long-term-mortality-in%C3%A2-patients-hospitalized-due-to-heart-failure
#14
You Zhong, Qays Almodares, JieFu Yang, Fang Wang, Michael Fu, Magnus C Johansson
PURPOSE: Reduced blood circulation is an important feature of heart failure, and Doppler stroke distance of the left ventricular outflow tract is a measure of forward stroke volume. Several echocardiographic parameters have known prognostic implications in heart failure, but the prognostic implications of stroke distance in relation to other parameters are insufficiently known. The aim was therefore to test the hypothesis that stroke distance is associated with five-year all-cause mortality, independently of other echocardiography variables, and that stroke distance has added long-term prognostic value...
January 9, 2018: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29305560/heart-failure-with-preserved-ejection-fraction-controversies-challenges-and-future-directions
#15
REVIEW
Rosita Zakeri, Martin R Cowie
Heart failure with preserved ejection fraction (HFpEF) comprises almost half of the population burden of HF. Because HFpEF likely includes a range of cardiac and non-cardiac abnormalities, typically in elderly patients, obtaining an accurate diagnosis may be challenging, not least due to the existence of multiple HFpEF mimics and a newly identified subset of patients with HFpEF and normal plasma natriuretic peptide concentrations. The lack of effective treatment for these patients represents a major unmet clinical need...
January 5, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#16
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29289956/outcomes-and-predictors-of-mortality-after-mitral-valve-surgery-in-high-risk-elderly-patients-the-heidelberg-experience
#17
Sabreen Mkalaluh, Marcin Szczechowicz, Bashar Dib, Gabor Szabo, Matthias Karck, Alexander Weymann
BACKGROUND Overall, life expectancy at the age of 80 has significantly increased in the industrialized world and the proportion of this age class undergoing cardiac surgery has also grown. In this context, we have analyzed a contemporary series of octogenarians undergoing mitral valve surgery at our institution. MATERIAL AND METHODS We performed a retrospective analysis of 138 consecutive octogenarians receiving mitral valve surgery between January 2006 and April 2017. Preoperative comorbidities, early mortality, postoperative clinical course, and predictors of mortality were examined...
December 31, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29286056/sacubitril-and-valsartan-fixed-combination-to-reduce-heart-failure-events-in-post-acute-myocardial-infarction-patients
#18
M Zaid Iskandar, C C Lang
Heart failure is a term used to define a constellation of symptoms and signs that are commonly attributed to the inability of the heart to produce a cardiac output that meets the demands of the body. It remains a deadly disease, affecting between 1-2% of the population, and is more common in the elderly, with around 6-10% of patients over 65 suffering from the condition. Sacubitril/valsartan (LCZ-696) is a combined neprilysin inhibitor and angiotensin AT1 receptor blocker approved in recent years for the treatment of chronic heart failure with reduced ejection fraction...
October 2017: Drugs of Today
https://www.readbyqxmd.com/read/29276931/-medication-adherence-of-elderly-patients-with-chronic-heart-failure
#19
V N Larina, I I Chukaeva, D G Karpenko, A V Pozdnyakova
The review is devoted to the problem of medication adherence in elderly patients with chronic heart failure. We consider here specificity of approach to management of elderly outpatients, groups of factors associated with medication adherence, and possible ways to improvement of compliance to treatment in patients from the senior age group with heart failure.
October 2017: Kardiologiia
https://www.readbyqxmd.com/read/29276792/hydration-health-literacy-in-the-elderly
#20
Dominic Picetti, Stephen Foster, Amanda K Pangle, Amy Schrader, Masil George, Jeanne Y Wei, Gohar Azhar
BACKGROUND: Inadequate hydration in the elderly is associated with increased morbidity and mortality. However, few studies have addressed the knowledge of elderly individuals regarding hydration in health and disease. Gaps in health literacy have been identified as a critical component in health maintenance, and promoting health literacy should improve outcomes related to hydration associated illnesses in the elderly. METHODS: We administered an anonymous survey to community-dwelling elderly (n = 170) to gauge their hydration knowledge...
December 7, 2017: Nutrition and Healthy Aging
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