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Geriatric Emergency

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https://www.readbyqxmd.com/read/29662881/the-continuum-of-aging-and-age-related-diseases-common-mechanisms-but-different-rates
#1
REVIEW
Claudio Franceschi, Paolo Garagnani, Cristina Morsiani, Maria Conte, Aurelia Santoro, Andrea Grignolio, Daniela Monti, Miriam Capri, Stefano Salvioli
Geroscience, the new interdisciplinary field that aims to understand the relationship between aging and chronic age-related diseases (ARDs) and geriatric syndromes (GSs), is based on epidemiological evidence and experimental data that aging is the major risk factor for such pathologies and assumes that aging and ARDs/GSs share a common set of basic biological mechanisms. A consequence is that the primary target of medicine is to combat aging instead of any single ARD/GSs one by one, as favored by the fragmentation into hundreds of specialties and sub-specialties...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29659475/frailty-screening-and-a-frailty-pathway-decrease-length-of-stay-loss-of-independence-and-30-day-readmission-rates-in-frail-geriatric-trauma-and-emergency-general-surgery-patients
#2
Kathryn E Engelhardt, Quentin Reuter, Jessica Liu, Jonathan F Bean, Joliette Barnum, Michael B Shapiro, Allison Ambre, Amanda Dunbar, Mara Markzon, Tara Reddy, Christine Schilling, Joseph Posluszny
BACKGROUND: Frail geriatric trauma and emergency general surgery (TEGS) patients have longer lengths of stay (LOS), more readmissions, and higher rates of post-discharge institutionalization than their non-frail counterparts. Despite calls to action by national trauma coalitions, there are few published reports of prospective interventions. The objective of this quality improvement (QI) project was to first develop a frailty screening program, and, then, if frail, implement a novel Frailty Pathway to reduce LOS, 30-day readmissions, and loss of independence (LOI)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659009/state-of-the-science-interprofessional-approaches-to-aging-dementia-and-mental-health
#3
Timothy W Farrell, Marilyn K Luptak, Katherine P Supiano, James T Pacala, Rosalind De Lisser
Interprofessional education (IPE) is essential to develop the healthcare workforce of the future. Geriatrics healthcare professionals have long championed innovations in IPE and patient care, but there is increased urgency to address challenges in aging, dementia, and geriatric mental health in America. In 2010, the Partnership for Health in Aging multidisciplinary competencies and a related position statement in the Journal of the American Geriatrics Society addressed interdisciplinary team (IDT) training in geriatrics...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29627192/why-do-the-very-old-self-harm-a-qualitative-study
#4
Anne P F Wand, Carmelle Peisah, Brian Draper, Henry Brodaty
OBJECTIVES: To examine the perspectives of people aged 80 years or older who self-harmed regarding their reasons for self-harm and its consequences, and their perceptions of care. DESIGN: A qualitative study using in-depth interviews. SETTING: Participants were recruited from two teaching hospitals and associated community services. PARTICIPANTS: People aged 80 years or older who had self-harmed within the previous month...
March 15, 2018: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29607245/future-of-health-findings-from-a-survey-of-stakeholders-on-the-future-of-health-and-healthcare-in-england
#5
Jennie Corbett, Camilla d'Angelo, Lorenzo Gangitano, Jon Freeman
This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly...
April 2018: Rand Health Quarterly
https://www.readbyqxmd.com/read/29601378/is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#6
Vimal Desai, Priscilla H Chan, Heather A Prentice, Gary L Zohman, Glenn R Diekmann, Gregory B Maletis, Brian H Fasig, Diana Diaz, Elena Chung, Chunyuan Qiu
BACKGROUND: Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. QUESTIONS/PURPOSES: (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? METHODS: We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29582533/potentially-inappropriate-medications-with-polypharmacy-increase-the-risk-of-falls-in-older-japanese-patients-1-year-prospective-cohort-study
#7
Shoichi Masumoto, Mikiya Sato, Takami Maeno, Yumiko Ichinohe, Tetsuhiro Maeno
AIM: We aimed to evaluate whether potentially inappropriate medications (PIMs) increase the risk for adverse clinical outcomes including falls, emergency department (ED) visits and unplanned hospitalizations in older Japanese patients with chronic diseases, comparing the difference between patients with and without polypharmacy. METHODS: A prospective observational cohort study was carried out in a Japanese outpatient primary care clinic. Baseline data was collected from January to March 2016...
March 26, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29573893/health-care-providers-perceptions-of-family-caregivers-involvement-in-consultations-within-a-geriatric-hospital-setting
#8
Daniela Koren, Rebekah Laidsaar-Powell, Wendy Tilden, Mark Latt, Phyllis Butow
This study explored health professionals' (HPs') experiences of interacting with family care-givers (FCs), and the strategies they employ during these interactions. Qualitative methods involved audio-taped and transcribed in-depth semi-structured interviews with 21 HPs (doctors, nurses) from the geriatric wards of two tertiary hospitals. Framework methods were used to analyze data. Seven main themes emerged: Variation in family behaviours; FCs face many challenges; Psychosocial factors influence FCs' behaviours; Attitudes, competing responsibilities and lack of resources influencing HPs' strategies and behaviours; Strategies employed by HPs to improve communication; HPs' self-care strategies; Impact of interactions on HPs and the healthcare system...
March 21, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29565018/impact-of-frailty-on-outcomes-after-discharge-in-older-surgical-patients-a-prospective-cohort-study
#9
Yibo Li, Jenelle L Pederson, Thomas A Churchill, Adrian S Wagg, Jayna M Holroyd-Leduc, Kannayiram Alagiakrishnan, Raj S Padwal, Rachel G Khadaroo
BACKGROUND: Frailty is a state of vulnerability to diverse stressors. We assessed the impact of frailty on outcomes after discharge in older surgical patients. METHODS: We prospectively followed patients 65 years of age or older who underwent emergency abdominal surgery at either of 2 tertiary care centres and who needed assistance with fewer than 3 activities of daily living. Preadmission frailty was defined according to the Canadian Study of Health and Aging Clinical Frailty Scale as "well" (score 1 or 2), "vulnerable" (score 3 or 4) or "frail" (score 5 or 6)...
February 20, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29564853/-self-supporting-care-model-for-older-adults
#10
Yen-Chun Lin, Lian-Hua Huang
Self-supporting care is an emerging concept in the geriatric care system of Taiwan. The traditional care model tends to prioritize aspects such as "safety" and "convenient and effective". For older adult patients, this situation has led to excessive restrictions, enforced bedrest, and the use of adult diapers, which seriously deteriorate quality of life. The present article introduces the development and current status of self-supporting care and international empirical research results from the perspective of holistic care for older adults as well as describes the intervention strategies that are currently used in Taiwan...
April 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29560835/how-argentina-is-training-their-mental-health-residents-to-face-its-silver-tsunami
#11
Sergio A Strejilevich, Florencia Vallejos, Julian Bustin
In low- and middle-income countries, there is an increase in the percentage of aging population similar to or greater than that of high-income countries (World Population Ageing 1950-2050, UN, 2001). The emerging health and economical challenges due to these demographic changes will have to be addressed by their health systems. In this context, an adequate training of available human resources in geriatric psychiatry/psychogeriatrics (GP/PG) should be an essential step to meet those challenges.
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29549205/diagnostic-accuracy-of-the-ottawa-3dy-and-short-blessed-test-to-detect-cognitive-dysfunction-in-geriatric-patients-presenting-to-the-emergency-department
#12
David Barbic, Brian Kim, Qadeem Salehmohamed, Kate Kemplin, Christopher R Carpenter, Skye Pamela Barbic
OBJECTIVES: Cognitive dysfunction (CD) is a common finding in geriatric patients presenting to the emergency department (ED). Our primary objective was to determine the diagnostic accuracy of the Ottawa 3DY (O3DY) and Short Blessed Test (SBT) as screening tools for the detection of CD in the ED. Our secondary objective was to estimate the inter-rater reliability of these instruments. METHODS: We conducted a prospective cross-sectional comparative study at an inner-city academic medical centre (annual ED visit census 86 000)...
March 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29547361/statement-on-minimum-standards-for-the-care-of-older-people-in-emergency-departments-by-the-geriatric-emergency-medicine-special-interest-group-of-the-international-federation-for-emergency-medicine-erratum
#13
Brittany Ellis, Christopher R Carpenter, Judy A Lowthian, Simon P Mooijaart, Christian H Nickel, Don Melady
No abstract text is available yet for this article.
March 16, 2018: CJEM
https://www.readbyqxmd.com/read/29546287/degree-of-peripheral-thyroxin-deiodination-frailty-and-long-term-survival-in-hospitalized-older-patients
#14
Giuseppe Pasqualetti, Valeria Calsolaro, Sara Bernardini, Giuseppe Linsalata, Renato Bigazzi, Nadia Caraccio, Fabio Monzani
Introduction: Although the association between low FT3 and poor outcome has been extensively reported in literature, the degree of peripheral thyroxin deiodination and its relationship with frailty and survival in hospitalized older patients has not been fully established yet. The aim of the current study was to evaluate the possible correlation between FT3/FT4 ratio reduction, an indirect marker of thyroxin deiodination impairment, and frailty status and survival in hospitalized older patients...
March 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29539602/stroke-referrals-from-nursing-homes-high-rate-of-mimics-and-late-presentation
#15
Markus Kneihsl, Christian Enzinger, Kurt Niederkorn, Gerit Wünsch, Lisa Müller, Valeriu Culea, Andreas Lueger, Franz Fazekas, Thomas Gattringer
BACKGROUND: Stroke has become a treatable condition with increasing evidence of treatment benefits in older people. However, stroke mimics in geriatric patients are especially prevalent, causing incorrect suspicion and consecutive burden to patients and emergency room resources. We therefore examined the dimension of this problem by investigating emergency room admissions from nursing homes for suspected stroke. METHODS: We performed a retrospective cohort study of all nursing home residents who were admitted to the neurological emergency room of our primary and tertiary care university hospital between 2013 and 2015...
March 14, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29532466/academic-detailing-with-provider-audit-and-feedback-improve-prescribing-quality-for-older-veterans
#16
Ann E Vandenberg, Katharina V Echt, Lawanda Kemp, Gerald McGwin, Molly M Perkins, Anna K Mirk
Suboptimal prescribing persists as a driver of poor quality care of older veterans and is associated with risk of hospitalization and emergency department visits. We adapted a successful medication management model, Integrated Management and Polypharmacy Review of Vulnerable Elders (IMPROVE), from an urban geriatric specialty clinic to rural community-based clinics that deliver primary care. The goals were to promote prescribing quality and safety for older adults, including reduced prescribing of potentially inappropriate medications (PIMs)...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29521617/retrospective-study-on-clonal-relationship-of-multidrug-resistant-klebsiella-spp-indicates-closed-circulation-and-initiation-of-clonal-divergence
#17
Debi Prasad Mohapatra, Santosh Kumar Singh, Minu Sahoo, Shashank Patole, Mitali Mishra, Nagen Kumar Debata, Harapriya Mohapatra
PURPOSE: Antibiotic resistance patterns often exhibit geographical variations. Periodic analyses of resistance spectra and phylogenetic trends are important guides for facilitating judicious use of therapeutic interventions. The present study retrospectively analysed the infection trends, resistance patterns, and clonal relationships between isolates of Klebsiella spp. from a tertiary care hospital. METHODOLOGY: Bacterial isolates were collected from January 2013 to June 2014 and their resistance profiles were identified using an automated bacterial identification system...
March 9, 2018: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29516212/electronic-assessment-of-physical-decline-in-geriatric-cancer-patients
#18
REVIEW
Ramin Fallahzadeh, Hassan Ghasemzadeh, Armin Shahrokni
PURPOSE OF REVIEW: The purpose of this review is to explore state-of-the-art remote monitoring and emerging new sensing technologies for in-home physical assessment and their application/potential in cancer care. In addition, we discuss the main functional and non-functional requirements and research challenges of employing such technologies in real-world settings. RECENT FINDINGS: With rapid growth in aging population, effective and efficient patient care has become an important topic...
March 8, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29511850/using-information-technology-in-the-assessment-and-monitoring-of-geriatric-oncology-patients
#19
REVIEW
Kah Poh Loh, Colin McHugh, Supriya G Mohile, Karen Mustian, Marie Flannery, Heidi Klepin, Rebecca Schnall, Eva Culakova, Erika Ramsdale
PURPOSE OF REVIEW: Older adults with cancer have complex medical needs and often experience higher rates of treatment-related toxicities compared to their younger counterparts. The advent of health information technologies can address multiple gaps in the care of this population. We review the role of existing and emerging technologies in facilitating the use of comprehensive geriatric assessment (CGA) in routine clinics, promoting symptom reporting, and monitoring medication adherence...
March 6, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29509505/trauma-in-the-elderly-patient
#20
Angela Atinga, Andreas Shekkeris, Michael Fertleman, Nicola Batrick, Elika Kashef, Elizabeth Dick
Major Trauma Centres and Emergency Departments are treating an increasing number of geriatric trauma patients in the UK. Elderly patients, generally defined as those over the age of 65 years, are more susceptible to injury from lesser mechanisms of trauma than younger adults. The number of geriatric trauma cases is rising yearly, accounting for > 25% of all major trauma cases nationally. The elderly have different physiological reserves and a different response to trauma, due to premorbid frailty, co-existing conditions and prescribed medication...
March 6, 2018: British Journal of Radiology
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