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Geriatric cardiology

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https://www.readbyqxmd.com/read/29759801/-evaluation-of-the-prescription-of-furosemide-in-persons-aged-75years-and-older-in-a-geriatric-acute-care-unit
#1
M Buttard, A Putot, P d'Athis, L Pioro, S Asgassou, S Putot, M Deïdda, C Laborde, M Dipanda, R Mahmoudi, P Manckoundia
INTRODUCTION: Furosemide is very often prescribed in France. It may cause important adverse effects especially in elderly persons. In order to limit its misuse and excessive expenditure for health insurance organizations, the European Society of Cardiology drafted strict guidelines for its prescription. We conducted a study in this population to determine the rate of prescription of furosemide in elderly persons outside the guidelines. METHOD: This was a prospective, single-centre, observational study bearing on elderly persons aged 75years and more admitted to a geriatric acute-care unit over a period of 6months...
May 11, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29699619/domain-management-approach-to-heart-failure-in-the-geriatric-patient-present-and-future
#2
REVIEW
Eiran Z Gorodeski, Parag Goyal, Scott L Hummel, Ashok Krishnaswami, Sarah J Goodlin, Linda L Hart, Daniel E Forman, Nanette K Wenger, James N Kirkpatrick, Karen P Alexander
Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy...
May 1, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29542108/improving-care-using-a-bidirectional-geriatric-cardiology-consultative-conference
#3
Eleonore V Grant, Adam H Skolnick, Joshua Chodosh, Michael H Perskin, Nicole M Orr, Caroline Blaum, John A Dodson
More than 13 million persons in the United States aged 65 and older have cardiovascular disease (CVD), and this population is expected to increase exponentially over the next several decades. In the absence of clinical studies that would inform how best to manage this population, there is an urgent need for collaborative, thoughtful approaches to their care. Although cardiologists are traditionally regarded as leaders in the care of older adults with CVD, these individuals have multiple comorbidities, physiological differences, and distinct goals of care than younger patients that require a specialized geriatric lens...
March 15, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29397583/post-stroke-hypertension-control-and-receipt-of-health-care-services-among-veterans
#4
Dhanashri D Kohok, Jason J Sico, Fitsum Baye, Laura Myers, Jessica Coffing, Masoor Kamalesh, Dawn M Bravata
Many ischemic stroke patients do not achieve goal blood pressure (BP < 140/90 mm Hg). To identify barriers to post-stroke hypertension management, we examined healthcare utilization and BP control in the year after index ischemic stroke admission. This retrospective cohort study included patients admitted for acute ischemic stroke to a VA hospital in fiscal year 2011 and who were discharged with a BP ≥ 140/90 mm Hg. One-year post-discharge, BP trajectories, utilization of primary care, specialty and ancillary services were studied...
February 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29260237/-anticoagulation-in-geriatric-patients-with-atrial-fibrillation-with-what-and-for-whom-no-more
#5
REVIEW
P Bahrmann, M Christ
Based on established risk scores, such as the CHA2 DS2 -VASc score, the indications for oral anticoagulation are given for patients over 65 years old with atrial fibrillation and even more so for patients over 75 years old. Before beginning anticoagulation a geriatric assessment for evaluation of the cognitive ability, the activities of daily living and the risk of falling should be made because of the known complications of anticoagulation. Geriatric patients with non-valvular atrial fibrillation (AF) are increasingly being treated with non-vitamin K antagonist oral anticoagulants (NOAC) to prevent ischemic stroke...
December 19, 2017: Herz
https://www.readbyqxmd.com/read/29242982/-iron-a-miralcle-cure-for-chronic-cardiac-insufficiency
#6
REVIEW
Katrin Singler
Anemia and chronic heart failure are frequent comorbidities in geriatric patients. In approximately one third of older adults the cause of the anemia is an iron, vitamin B12 and/or folate deficiency and in another third a chronic inflammatory process is present. In the case of iron deficiency a differentiation must be made between the absolute and functional forms. Although in functional iron deficiency ferritin, as a parameter of iron metabolism, is within the normal range or can even be higher, an iron-deficient erythropoiesis is present...
February 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29187325/relevance-of-g8-scale-in-referring-elderly-patients-with-aortic-stenosis-requiring-a-tavi-for-a-geriatric-consultation
#7
Albane de Thézy, Aurélie Lafargue, Lydie d'Arailh, Marina Dijos, Lionel Leroux, Nathalie Salles, Muriel Rainfray
Aortic stenosis (AS) may soon become a significant public health issue. Referring elderly suffering from aortic stenosis for a transcatheter aortic valve implantation (TAVI) versus surgical valve replacement might be difficult and requires a multidisciplinary staff. G8 is a geriatric screening scale for frailty, validated in oncogeriatry. We study sensibility and specificity of G8 used by cardiologists in comparison to a comprehensive geriatric assessment (CGA) performed by geriatrician. Prospective study, from February to July 2015, in Bordeaux university Hospital, France...
December 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29168884/transformation-of-a-geriatric-department-in-china
#8
Birong Dong, Jirong Yue, Li Cao, Ming Yang, Ning Ge, Hao Qiukui, Lujia He, Ying Wang, Joseph H Flaherty
China has the world's largest elderly population, and the oldest-old population, with a current disability rate greater than 50%, will triple in the next 35 years. The field of geriatrics is young, because almost all geriatric departments were established after 2000, and so faces many challenges. Management of diseases and hospital care is the focus. Senior physicians were trained in other subspecialties, such as pulmonary or cardiology, and junior physicians entered geriatrics departments as masters or doctorate students after medical school...
January 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28976384/-infective-endocarditis-in-elderly-patients
#9
Serap Şimşek Yavuz
Infective endocarditis (IE) is a rare disease, but it is still associated with high mortality and elderly represent a growing proportion of patients with this disease. At the moment, more than one third of the IE patients is over 70 years old in developed countries. Although mean age of patients with endocarditis is still between 40 and 50 years old in our country, it is a fact that more elderly patients with IE will be seen in the coming years because of the prolongation of the life span and the increase in the proportion of the elderly...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28967719/cardiac-surgery-in-the-elderly-what-goals-of-care
#10
Alessandra Pratesi, Francesco Orso, Camilla Ghiara, Aldo Lo Forte, Anna Chiara Baroncini, Maria Laura Di Meo, Emanuele Carassi, Samuele Baldasseroni
At present, the majority of cardiac surgery interventions have been performed in the elderly with successful short-term mortality and morbidity, however significant difficulties must to be underlined about our capacity to predict long-term outcomes such as disability, worsening quality of life and loss of functional capacity.The reason probably resides on inability to capture preoperative frailty phenotype with current cardiac surgery risk scores and consequently we are unable to outline the postoperative trajectory of an important patients' centered outcome such as disability free survival...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967714/preoperative-risk-evaluation-in-patients-over-75-years-candidates-to-non-cardiac-and-cardiac-surgery
#11
Alessandro Boccanelli, Pompilio Faggiano
In the 24th and 25thof June 2016, 80 national experts were invited to Rome from The Italian Society of Geriatric Cardiology and the Italian Association of Cardiovascular Prevention and Rehabilitation to revise the current knowledge on the perioperative risk in the elderly. Cardiologists, geriatricians, heart and general surgeons and anesthesiologists discussed the topic with the objective of reaching a consensus and to launch observational research and registries in the field of perioperative risk evaluation in the elderly...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28958009/masked-hypertension-is-associated-with-cognitive-decline-in-geriatric-age-geriatric-masked-hypertension-and-cognition-g-mash-cog-study
#12
Mert Esme, Burcu Balam Yavuz, Bunyamin Yavuz, Serkan Asil, Rana Tuna Dogrul, Fatih Sumer, Mustafa Kemal Kilic, Muhammet Cemal Kizilarslanoglu, Hacer Dogan Varan, Aykut Sagir, Cafer Balci, Meltem Halil, Mustafa Cankurtaran
Background: Masked hypertension is described as high ambulatory blood pressure measurements (ABPM) where office blood pressure measurements are normal. Effect of hypertension on cognitive functions is well known. However, the effect of masked hypertension on cognitive functions is unclear. The aim of this study is to examine the relationship between masked hypertension and cognitive functions. Methods: One hundred-two normotensive patients admitted to the Geriatric Medicine outpatient clinic were included...
January 16, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28933175/-hiv-infection-a-new-disease-of-internal-medicine
#13
Svatava Snopková
Modern antiretroviral treatment belongs to the greatest success of current medicine. HIV infection has gone from a death sentence to a manageable chronic disease which develops several decades. Thanks to treatment advances, people with HIV can and do live long and full lives. In the last two decades, the incidence AIDS defining illnesses have been dramatically reduced especially opportunistic infections and malignancies, whereas the role of non-infection comorbidities has risen than age-matched HIV uninfected adults...
December 0: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28868075/determinants-of-invasive-strategy-in-elderly-patients-with-non-st-elevation-myocardial-infarction
#14
Antonin Negers, Jacques Boddaert, Lucie Mora, Jean-Louis Golmard, Laura Moïsi, Ariel Cohen, Jean-Philippe Collet, Alice Breining
BACKGROUND: Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit from invasive strategy (IS) in non ST-elevation myocardial infarction (NSTEMI). Furthermore, the benefit of IS in a real-world elderly population with NSTEMI remains unclear. The aims of this study were to determine factors that lead the cardiologist to opt for an IS in elderly patients with NSTEMI, and to assess the impact of IS on the 6-month all-cause mortality...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28729895/what-can-geriatrics-teach-cardiology
#15
Kumar Dharmarajan
No abstract text is available yet for this article.
November 2016: Current Cardiovascular Risk Reports
https://www.readbyqxmd.com/read/28699936/clinician-attitudes-regarding-icd-deactivation-in-dnr-dni-patients
#16
Andrew Bradley, Adam Marks
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) offer lifesaving therapies but can become burdensome at the end of life. Many ICD patients choose to implement a do-not-resuscitate/do-not-intubate (DNR/DNI) order. When hospitalized, patients are seen by a range of clinicians whose beliefs about ICD management in DNR/DNI patients may vary. OBJECTIVE: To assess clinician opinions on managing ICDs in DNR/DNI patients and stratify it by specialty and training level...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28663759/new-challenges-of-geriatric-cardiology-from-clinical-to-preclinical-research
#17
Marco Malavolta, Daniele Caraceni, Fabiola Olivieri, Roberto Antonicelli
The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases (CVD). The burden of CVD is expected to increase particularly for the most common types of chronic heart disease of the elderly including coronary artery disease, heart failure and atrial fibrillation. In this context of dramatic demographic changes, geriatric cardiologists are facing important challenges. In this review, we outline the basic concepts of geriatric cardiology and describe these challenges as well as the unmet needs around this discipline with also a focus on the translation from basic research...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28593039/is-it-time-for-comprehensive-geriatric-assessment-to-move-beyond-primary-care-the-case-for-targeting-medical-sub-specialty-practice
#18
Laura K Byerly, G Michael Harper
Comprehensive geriatric assessment (CGA) as a consultative service for older adults with complex medical and psychosocial challenges has existed for decades. However, studies have often showed inconsistent acceptance and implementation of geriatric recommendations by primary care providers (PCPs) raising doubts about the overall benefits of CGA in this setting. Press and colleagues investigated the patient- and provider-related factors that affect recommendation implementation, and like previous studies, they too found similarly low rates of implementation...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28422280/integrating-frailty-research-into-the-medical-specialties-report-from-a-u13-conference
#19
Jeremy Walston, Thomas N Robinson, Susan Zieman, Frances McFarland, Christopher R Carpenter, Keri N Althoff, Melissa K Andrew, Caroline S Blaum, Patrick J Brown, Brian Buta, E Wesley Ely, Luigi Ferrucci, Kevin P High, Stephen B Kritchevsky, Kenneth Rockwood, Kenneth E Schmader, Felipe Sierra, Kaycee M Sink, Ravi Varadhan, Arti Hurria
Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency virus care, and nephrology, and in the behavioral and social sciences. Lack of a consensus definition, proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for frail individuals hinders incorporation of frailty assessment and frailty research into the specialties...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#20
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
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