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Geriatric Emergency

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https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#1
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#2
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28187736/thrombocytopenia-on-the-first-day-of-emergency-department-visit-predicts-higher-risk-of-acute-kidney-injury-among-elderly-patients
#3
Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang
BACKGROUND: Few studies have addressed risk factors for acute kidney injury (AKI) in geriatric patients. We investigated whether thrombocytopenia was a risk factor for AKI in geriatric patients with medical illnesses. METHODS: A prospective cohort study was conducted, by recruiting elderly (≥65 years) patients who visited the emergency department (ED) for medical illnesses during 2014. They all received hemogram for platelet count determination, and were stratified according to the presence of thrombocytopenia (platelets, <150 K/μL) during their initial ED evaluation...
February 10, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28186638/psychotherapy-utilization-and-retention-in-a-national-sample-of-veterans-with-ptsd
#4
Jennifer M Doran, Robert H Pietrzak, Rani Hoff, Ilan Harpaz-Rotem
OBJECTIVE: This study examines the demographic, diagnostic, and military variables associated with psychotherapy utilization and retention in a national Veteran sample. METHOD: A large administrative VA dataset (142,620 Veterans) was utilized. Logistic regression was used to determine predictors of psychotherapy utilization and retention. RESULTS: Female gender was associat ed with increased psychotherapy utilization and retention. Geriatric age was associated with less retention in individual psychotherapy...
February 10, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28183322/impact-of-a-pharmacist-led-medication-review-on-hospital-readmission-in-a-pediatric-and-elderly-population-study-protocol-for-a-randomized-open-label-controlled-trial
#5
Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28182802/the-association-of-geriatric-syndromes-with-hospital-outcomes
#6
Roman Romero-Ortuno, Duncan R Forsyth, Kathryn Jane Wilson, Ewen Cameron, Stephen Wallis, Richard Biram, Victoria Keevil
BACKGROUND: Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital. OBJECTIVE: To study the association of frailty (≥6 points in the Clinical Frailty Scale [CFS]), HoD, and ACS with hospital outcomes, controlling for age, gender, acute illness severity (measured by a Modified Early Warning Score in the emergency department), comorbidity (Charlson Comorbidity Index), and discharging specialty (general medicine, geriatric medicine, surgery)...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28178398/delphi-survey-of-clinical-nursing-and-midwifery-research-priorities-in-the-eastern-mediterranean-region
#7
Carolyn Sun, Jennifer Dohrn, Arwa Oweis, Huda Abu-Saad Huijer, Fathieh Abu-Moghli, Hania Dawani, Cheherezade Ghazi, Elaine Larson
PURPOSE: As the shortage of nurses and midwives is expected to worsen in the Eastern Mediterranean region concomitantly with a growing focus on achievement of universal health coverage, nurses and midwives are expected to fill major gaps in health care. Hence, the need for a solid evidence base for nursing practice and a clear direction for clinical nursing research are paramount. Therefore, a Delphi survey was conducted to determine clinical (research focused on patient outcomes) nursing and midwifery priorities for research within this region...
February 8, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28168829/exploring-dental-student-participation-in-interdisciplinary-care-team-conferences-in-long-term-care
#8
Jeremy Huynh, Leeann R Donnelly, Mario A Brondani
OBJECTIVE: The purpose of this study was to explore how the participation of dental hygiene students in interdisciplinary care conferences conducted in long-term care (LTC) facilities influenced the staff's awareness of oral health, the student's provision of care as well as the student's ability to work on an interdisciplinary team. BACKGROUND: Oral health in LTC continues to be poor despite many educational and clinical interventions. The care of a frail elder requires an interdisciplinary team approach, yet dental professionals are often absent from these teams...
February 7, 2017: Gerodontology
https://www.readbyqxmd.com/read/28143449/cancers-of-unknown-primary-diagnosed-during-hospitalization-a-population-based-study
#9
William Jones, Gwen Allardice, Iona Scott, Karin Oien, David Brewster, David S Morrison
BACKGROUND: Cancers of Unknown Primary (CUP) are the 3-4(th) most common causes of cancer death and recent clinical guidelines recommend that patients should be directed to a team dedicated to their care. Our aim was to inform the care of patients diagnosed with CUP during hospital admission. METHODS: Descriptive study using hospital admissions (Scottish Morbidity Record 01) linked to cancer registrations (ICD-10 C77-80) and death records from 1998 to 2011 in West of Scotland, UK (population 2...
January 31, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28131609/geriatric-syncope-and-cardiovascular-risk-in-the-emergency-department
#10
Nissa J Ali, Shamai A Grossman
BACKGROUND: Syncope is a transient loss of consciousness that is caused by a brief loss in generalized cerebral blood flow. OBJECTIVE: This article reviews the background, epidemiology, etiologies, evaluation, and disposition considerations of geriatric patients with syncope, with a focus on cardiovascular risk. DISCUSSION: Although syncope is one of the most common symptoms in elderly patients presenting to the emergency department, syncope causes in geriatric patients can present differently than in younger populations, and the underlying etiology is often challenging to discern...
January 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28125958/long-term-mortality-in-older-patients-discharged-after-acute-decompensated-heart-failure-a-prospective-cohort-study
#11
Pierre-André Natella, Philippe Le Corvoisier, Elena Paillaud, Bertrand Renaud, Isabelle Mahé, Jean-François Bergmann, Hervé Perchet, Dominique Mottier, Olivier Montagne, Sylvie Bastuji-Garin
BACKGROUND: Data are available on short- and intermediate-term mortality rates after discharge for acutely decompensated heart failure (ADHF). However, few studies specifically addressed ADHF outcomes in patients aged 75 years or over, who contribute more than half of all ADHF admissions. Our objectives here were to estimate the long-term mortality of patients aged 75 years or over who were discharged after admission for ADHF and to identify factors, especially geriatric findings, independently associated with 2-year mortality...
January 26, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28125760/resource-use-and-medicare-costs-during-lay-navigation-for-geriatric-patients-with-cancer
#12
Gabrielle B Rocque, Maria Pisu, Bradford E Jackson, Elizabeth A Kvale, Wendy Demark-Wahnefried, Michelle Y Martin, Karen Meneses, Yufeng Li, Richard A Taylor, Aras Acemgil, Courtney P Williams, Nedra Lisovicz, Mona Fouad, Kelly M Kenzik, Edward E Partridge
Importance: Lay navigators in the Patient Care Connect Program support patients with cancer from diagnosis through survivorship to end of life. They empower patients to engage in their health care and navigate them through the increasingly complex health care system. Navigation programs can improve access to care, enhance coordination of care, and overcome barriers to timely, high-quality health care. However, few data exist regarding the financial implications of implementing a lay navigation program...
January 26, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28124479/is-spinal-surgery-safe-in-octogenarians
#13
Harrison G Mihailidis, Simon Manners, Leonid Churilov, Gerald M Y Quan
BACKGROUND: An ageing population and advances in medical management often requires spinal surgeons to increasingly operate on patients older than 80 years. The ability to predict complications and mortality rates would allow discrimination of which octogenarians are able to safely undergo spinal surgery. Therefore, the aims of this study were to determine whether comorbidities and extent of surgery were associated with complications in this age group, in addition to which comorbidity and physical status assessment scales were best associated with the development of complications following spinal surgery...
January 26, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28120773/medication-reconciliation-a-tool-to-prevent-adverse-drug-events-in-geriatrics-medicine
#14
Anaïs Berthe, Clémentine Fronteau, Éloïse Le Fur, Caroline Morin, Jean-François Huon, Isabelle Rouiller-Furic, Marielle Berlioz-Thibal, Gilles Berrut, Aline Lepelletier
Iatrogenic effects represent a large part of emergency admissions among elderly people. Throughout the care pathway of a patient, whether he is at home or hospitalized, many different health professionals are involved regarding the patient's medication. Medication reconciliation is one way to prevent adverse drug events at all care transitions for every patient by eliminating undocumented intentional discrepancies and unintentional discrepancies in the patient's medication. The aim of this article is to present the different activities of clinical pharmacy developed since 2011 in a follow up and rehabilitation geriatric care service, including medication reconciliation activity...
January 23, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28112343/-intestinal-obstruction-due-to-ascaris-lumbricoides-infection-in-a-geriatric-patient
#15
Alfredo Chiappe, Kovy Arteaga, Cristhian Resurrección, Marcos Ñavincopa, Eduardo Ticona
Ascaris lumbricoides is considered the largest intestinal nematode with a higher incidence in the childhood, representing a truly medical and public health problem, principally in undeveloped countries. We present the case of an 83 year old man, born and coming from the amazon region, without any relevant previous history of disease, admitted in the emergency department of our hospital for presenting intestinal obstruction and also presumptive biliary obstruction due to multiple balls of parasites, requiring immediate surgical intervention...
October 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28106511/telementoring-primary-care-clinicians-to-improve-geriatric-mental-health-care
#16
Elisa Fisher, Michael Hasselberg, Yeates Conwell, Linda Weiss, Norma A Padrón, Erin Tiernan, Jurgis Karuza, Jeremy Donath, José A Pagán
Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016...
January 20, 2017: Population Health Management
https://www.readbyqxmd.com/read/28104098/urine-cultures-in-hospitalized-geriatric-patients-presenting-with-fever
#17
Zvi Shimoni, Ruslan Avdiaev, Paul Froom
INTRODUCTION: Urine cultures are commonly ordered in geriatric patients presenting with fever in the emergency department, but it is unclear if indiscriminate urine culture testing is warranted. MATERIALS AND METHODS: We selected 708 consecutive geriatric patients with a chief complaint of fever to determine the clinical usage (changes in antibiotic therapy according to culture results) and the costs of culturing the urine that included the need for catheterization to obtain a sample for culture and complications from catheterization...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28096642/awareness-of-osteoporosis-in-postmenopausal-indian-women-an-evaluation-of-osteoporosis-health-belief-scale
#18
Nirmal Raj Gopinathan, Ramesh Kumar Sen, Prateek Behera, Sameer Aggarwal, Niranjan Khandelwal, Mitali Sen
CONTEXT: The level of awareness about osteoporosis in postmenopausal women who are the common sufferers. AIMS: This study aims to evaluate the level of awareness in postmenopausal women using the Osteoporosis Health Belief Scale (OHBS). SETTINGS AND DESIGN: Osteoporosis has emerged as a common health problem in geriatric population. A proactive role needs to be played for preventing its consequences. Before initiating any preventive measures, an evaluation of awareness level of the target population is necessary...
October 2016: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28077927/utility-of-self-competency-ratings-during-residency-training-in-family-medicine-education-emerging-countries-findings-from-japan
#19
Michael D Fetters, Satoko Motohara, Lauren Ivey, Keiichiro Narumoto, Kiyoshi Sano, Masahiko Terada, Tsukasa Tsuda, Machiko Inoue
BACKGROUND: Family medicine education-emerging countries face challenges in demonstrating a new program's ability to train residents in womb-to-tomb care and resident ability to provide such care competently. We illustrate the experience of a new Japanese family medicine program with resident self-competency assessments. METHODS: In this longitudinal cross-sectional study, residents completed self-competency assessment surveys online during 2011-2015. Each year of training, residents self-ranked their competence using a 100-point visual analog scale for 142 conditions: acute (30 conditions), chronic (28 conditions) women's health (eight conditions), and geriatrics/home (12 conditions) care; procedures (38 types); health promotion (21 conditions)...
2017: Asia Pacific Family Medicine
https://www.readbyqxmd.com/read/28057200/epidemiology-and-recent-trends-of-geriatric-fractures-presenting-to-the-emergency-department-for-united-states-population-from-year-2004-2014
#20
N K Baidwan, S M Naranje
OBJECTIVES: Fractures in geriatric age group (over 65 years of age) are an important public health issue and frequent causes of emergency room visits. The purpose of this descriptive epidemiological study was to present the epidemiology of geriatric fractures and their trends in the USA using National Electronic Injury Surveillance System (NEISS) database from year 2004-2014. METHODS: National Electronic Injury Surveillance System (NEISS) Database was queried for all fracture injuries from 2004 to 2014 for ages 65 years and above...
January 2017: Public Health
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