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https://www.readbyqxmd.com/read/29154053/acupuncture-and-kinesio-taping-for-the-acute-management-of-bell-s-palsy-a-case-report
#1
Derya Özmen Alptekin
BACKGROUND: Bell's palsy is an idiopathic, acute peripheral palsy of the facial nerve that supplies the muscles of facial expression. Despite an expected 70% full recovery rate, up to 30% of patients are left with potentially disfiguring facial weakness, involuntary movements, or persistent lacrimation. The most frequently used treatment options are corticosteroids and antiviral drugs. However, accompanying clinical conditions, such as uncontrolled diabetes, hypertension, gastrointestinal disturbances, polypharmacy of geriatric patients, and significant sequelae ratios, indicate the need for safe and effective complementary therapies that would enhance the success of the conventional interventions...
December 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29149866/prevalence-and-risk-factors-of-frailty-among-home-care-clients
#2
Minna Miettinen, Miia Tiihonen, Sirpa Hartikainen, Irma Nykänen
BACKGROUND: Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. METHODS: The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland...
November 17, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29139041/drug-safety-analysis-in-a-real-life-cohort-of-parkinson-s-disease-patients-with-polypharmacy
#3
Saskia Müller-Rebstein, Claudia Trenkwalder, Jens Ebentheuer, Wolfgang H Oertel, Carsten Culmsee, Günter U Höglinger
BACKGROUND: Polypharmacy is common in geriatric Parkinson's disease (PD) patients in advanced disease stages with multiple comorbidities, bearing multiple risks for drug safety in theory. OBJECTIVE: The aim of this study was to empirically identify the most frequent and relevant contraindications and drug interactions actually occurring and compromising drug safety in PD in real life. METHODS: We conducted a prospective observational study in a multimorbid cohort of PD patients with polypharmacy admitted to a specialized hospital...
November 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/29133497/comparative-associations-between-measures-of-anti-cholinergic-burden-and-adverse-clinical-outcomes
#4
Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
PURPOSE: No consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults. METHODS: From Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up...
November 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/29128438/renin-angiotensin-system-blockers-and-statins-are-associated-with-lower-in-hospital-mortality-in-very-elderly-hypertensives
#5
Francesco Spannella, Federico Giulietti, Paolo Balietti, Guido Cocci, Laura Landi, Francesca Elena Lombardi, Elisabetta Borioni, Beatrice Bernardi, Giulia Rosettani, Valentina Bordoni, Riccardo Sarzani
OBJECTIVES: Cardiovascular diseases are mainly related to hypertension and dyslipidemia and increase with aging because of the larger time span for these risk factors to damage arterial blood vessels. The impact of cardiovascular drug therapy on outcomes in the very elderly hospitalized is still not well established. The aim of our study was to evaluate the associations between cardiovascular therapy and in-hospital mortality in very elderly hypertensives. DESIGN: Prospective observational study...
November 8, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29125004/impact-of-the-automated-dose-dispensing-with-medication-review-on-geriatric-primary-care-patients-drug-use-in-finland-a-nationwide-cohort-study-with-matched-controls
#6
Juha Sinnemäki, Marja Airaksinen, Maria Valaste, Leena K Saastamoinen
OBJECTIVE: In an automated dose dispensing (ADD) service, medicines are dispensed in unit-dose bags according to administration times. When the service is initiated, the patient's medication list is reconciled and a prescription review is conducted. The service is expected to reduce drug use. The aim of this national controlled study was to investigate whether the ADD service with medication review reduces drug use among geriatric primary care patients. DESIGN, SETTING AND PATIENTS: This is a nationwide cohort study with matched controls...
November 10, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29121542/risk-factors-for-three-month-mortality-after-discharge-in-a-cohort-of-non-oncologic-hospitalized-elderly-patients-results-from-the-reposi-study
#7
Luca Pasina, Laura Cortesi, Mara Tiraboschi, Alessandro Nobili, Giovanna Lanzo, Mauro Tettamanti, Carlotta Franchi, Pier Mannuccio Mannucci, Silvia Ghidoni, Andrea Assolari, Antonio Brucato
BACKGROUND: Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients...
November 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29109936/a-study-of-harmful-drug-drug-interactions-due-to-polypharmacy-in-hospitalized-patients-in-goa-medical-college
#8
Akshay Khandeparkar, Padmanabh V Rataboli
Introduction: Concomitant use of multiple drugs is often indicated to manage comorbid conditions and enhance efficacy. Such concomitant use of multiple drugs (five or more drugs) has been defined as "polypharmacy." Polypharmacy has been associated with adverse consequences such as greater healthcare costs, increased risk of adverse drug events, drug-drug interactions (DDIs), medication nonadherence, reduced functional capacity, and multiple geriatric syndromes. This study evaluated number of potential harmful DDIs due to polypharmacy...
October 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/29109625/postoperative-delirium-in-elderly-citizens-and-current-practice
#9
REVIEW
Siddareddygari Velayudha Reddy, Jawaharlal Narayanasa Irkal, Ananthapuram Srinivasamurthy
Postoperative delirium (POD) represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29105246/role-of-potentially-inappropriate-medication-use-in-rehabilitation-outcomes-for-geriatric-patients-after-strokes
#10
Eiji Kose, Toshiyuki Hirai, Toshiichi Seki, Hiroyuki Hayashi
AIM: The effect of the use of potentially inappropriate medications (PIM) on mortality and functional outcome after strokes is unclear in Japan. The aim of the present study was to establish whether treatment with PIM affects functional improvements among geriatric patients convalescing after strokes. METHODS: This retrospective longitudinal study included consecutive geriatric patients admitted and discharged from convalescent rehabilitation wards for stroke between 2010 and 2016...
November 3, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29094499/emergency-medicine-in-the-extreme-geriatric-era-a-retrospective-analysis-of-patients-aged-in-their-mid-90s-and-older-in-the-emergency-department
#11
Martin Müller, Meret E Ricklin, Stefan Weiler, Aristomenis K Exadaktylos, Spyridon Arampatzis
AIM: In the coming years, older individuals will comprise an increasing share of emergency department (ED) admissions, due to the unprecedented and continuing demographic changes. The primary aim of the present study was to identify causes and risk factors for ED admission and hospitalizations in the oldest old. METHODS: We analyzed data of consecutive patients aged in their mid 90s and older (aged ≥94 years) admitted to the ED department of the University Hospital of Bern, Bern, Switzerland, between 2000 and 2010...
November 2, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29089750/inappropriate-pharmacological-treatment-in-older-adults-affected-by-cardiovascular-disease-and-other-chronic-comorbidities-a-systematic-literature-review-to-identify-potentially-inappropriate-prescription-indicators
#12
Ersilia Lucenteforte, Niccolò Lombardi, Davide Liborio Vetrano, Domenico La Carpia, Zuzana Mitrova, Ursula Kirchmayer, Giovanni Corrao, Francesco Lapi, Alessandro Mugelli, Alfredo Vannacci
Avoiding medications in which the risks outweigh the benefits in the elderly patient is a challenge for physicians, and different criteria to identify inappropriate prescription (IP) exist to aid prescribers. Definition of IP indicators in the Italian geriatric population affected by cardiovascular disease and chronic comorbidities could be extremely useful for prescribers and could offer advantages from a public health perspective. The purpose of the present study was to identify IP indicators by means of a systematic literature review coupled with consensus criteria...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29081401/inadequate-drug-prescribing-comparison-of-inappropriate-drug-rates-at-the-end-of-a-geriatric-short-stay-service-with-three-prescribing-tools
#13
Jean-Luc Fanon, Sandra Dechavigny, Moustapha Dramé, Lidvine Godaert
To compare the proportion of prescriptions containing at least one inappropriate drug, as identified using three tools for optimizing drug prescriptions in the elderly. Cross-sectional, observational study based on the analysis of prescriptions of patients discharged between 1 September and 31 October 2014 in a short-stay geriatrics unit at the Louis Domergue de Trinité Hospital in Martinique (France). Each prescription was analysed using 3 tools, namely one for general medicine (Vidal © drug dictionary) and two tools specifically designed for geriatrics (the Laroche list of potentially inappropriate medications, and the STOPP-START toolkit)...
October 27, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29081189/-clinical-features-and-prognosis-of-93-elderly-patients-with-multiple-myeloma
#14
H M Chen, F Zhou, W Wei, R Peng, H T Shi, J Hou
Objective: To explore the clinical features and prognostic factors of elderly MM patients. Methods: A retrospectively analysis of clinical characteristics in 93 newly diagnosed MM patients with more than 70 years of old between August 2011 and August 2016. Based on age, basic activities of daily living scale, instrumental activities of daily living scale, Charlson comorbidity index at diagnosis, patients were divided into three groups: Fit (score=0, n=15) , Intermediate fitness (score=1, n=31) , Frail (score≥2, n=47) according to a geriatric assessment system proposed by Antonio Palumbo et al...
September 14, 2017: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
https://www.readbyqxmd.com/read/29066874/optimization-of-drug-therapy-in-elderly-individuals-admitted-to-a-geriatric-unit
#15
Antoine Piau, Yoann Huet, Adeline Gallini, Laurine Andre, Bruno Vellas, Fati Nourhashemi
BACKGROUND: A substantial share of adverse drug events involves inappropriate prescribing (IP). Specialized geriatric units are supposed to pay particular attention to prescribing appropriateness and to promoting a higher prescribing quality. OBJECTIVE: The objective of this study was to evaluate the reality of such assessment and optimization in real life (usual care) in a population of elderly individuals admitted to a geriatric unit. METHOD: This is an observational study including all older patients admitted to an acute geriatric unit over a 6-month period...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29049325/effect-of-therapeutic-interchange-on-medication-reconciliation-during-hospitalization-and-upon-discharge-in-a-geriatric-population
#16
Jessica S Wang, Robert L Fogerty, Leora I Horwitz
BACKGROUND: Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange. METHODS AND FINDINGS: Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs), histamine H2-receptor antagonists (H2 blockers), hydroxymethylglutaryl CoA reductase inhibitors (statins), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and inhaled corticosteroids (ICS)...
2017: PloS One
https://www.readbyqxmd.com/read/29048983/representation-of-women-and-minorities-in-clinical-trials-for-new-molecular-entities-and-original-therapeutic-biologics-approved-by-fda-cder-from-2013-to-2015
#17
Alice Chen, Hilary Wright, Hawi Itana, Merina Elahi, Ayomide Igun, Guoxing Soon, Anne R Pariser, Emmanuel O Fadiran
BACKGROUND: The U.S. Food and Drug Administration (FDA) has made efforts to encourage adequate assessment of women, racial/ethnic minorities, and geriatric participants in clinical trials through regulations and guidance documents. This study surveyed the demographics of clinical trial participants and the presence of efficacy and safety analyses by sex for new drugs approved between 2013 and 2015 by the FDA Center for Drug Evaluation and Research. METHODS: New drug marketing applications submitted to FDA were surveyed for demographic data (sex, race, ethnicity, and age) and the presence of sex-based analyses for efficacy and safety...
October 19, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29029665/mohs-micrographic-surgery-key-pharmacologic-considerations
#18
Diana Fischer, Patricia Orlando, Laura Shane-McWhorter
OBJECTIVE: To describe Mohs micrographic surgery and evaluate whether direct oral anticoagulants should be withheld in patients with atrial fibrillation (Afib) prior to the procedure and to consider what type of antibiotic prophylaxis should be used. SETTING: A community setting in which an elderly patient is living independently at home. PRACTICE DESCRIPTION: Academic-affiliated internal medicine clinic that cares for adult patients of all ages, including elderly patients living independently in their own home...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29027300/pattern-of-in-hospital-changes-in-drug-use-in-the-older-people-from-2010-to-2016
#19
C Franchi, I Ardoino, A Nobili, L Pasina, P M Mannucci, A Maregoni, F Perticone
PURPOSE: To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. METHODS: People aged 65 years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy)...
October 13, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28992984/avoidable-hospitalizations-due-to-adverse-drug-reactions-in-an-acute-geriatric-unit-analysis-of-3-292-patients
#20
Mateu Cabré, Lorena Elias, Mireia Garcia, Elisabet Palomera, Mateu Serra-Prat
OBJECTIVE: To determine prevalence of admissions due to an adverse drug reaction (ADR) and determine whether or not admission was avoidable, and what drugs and risk factors were implicated. DESIGN: Cross-sectional observational study. STUDY SAMPLE: All patients hospitalized in an acute geriatric unit during the period January 2001 to December 2010 were studied. MEASUREMENT: To determine whether admissions were due toADR, we used the World Health Organization-Uppsala Monitoring Centre criteria and the Naranjo scale...
October 6, 2017: Medicina Clínica
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