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Elderly fall medication

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https://www.readbyqxmd.com/read/28807522/orthostatic-hypotension-a-practical-approach-to-investigation-and-management
#1
Amy C Arnold, Satish R Raj
The maintenance of blood pressure upon the assumption of upright posture depends on rapid cardiovascular adaptations driven primarily by the autonomic nervous system. Failure of these compensatory mechanisms can result in orthostatic hypotension (OH), defined as sustained reduction in systolic blood pressure > 20 mm Hg or diastolic blood pressure > 10 mm Hg within 3 minutes of standing or > 60° head-up tilt. OH is a common finding, particularly in elderly populations, associated with cardiovascular and cerebrovascular morbidity and mortality...
May 17, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28807429/the-incidence-and-trauma-mechanisms-of-acetabular-fractures-a-nationwide-study-in-finland-between-1997-and-2014
#2
Pasi P Rinne, Minna K Laitinen, Tuomas Huttunen, Pekka Kannus, Ville M Mattila
PURPOSE: Information on the incidence of acetabular fractures of the pelvis is limited. Epidemiological data is often based on specific trauma registers, individual trauma centres or on trends of all pelvic fractures grouped together. The primary aim of this study was to determine the incidence and trends of hospital-treated acetabular fractures in the Finnish population from 1997 to 2014. The secondary aim was to assess the trauma mechanisms involved. METHODS: The Finnish National Hospital Discharge Register collects inpatient data from all public and private medical institutions in Finland and covers the entire Finnish population of 5...
August 4, 2017: Injury
https://www.readbyqxmd.com/read/28802465/integrative-medicine-for-geriatric-and-palliative-care
#3
REVIEW
Mikhail Kogan, Stephanie Cheng, Seema Rao, Sharon DeMocker, Mariatu Koroma Nelson
More than 80% of people in the United States who are older than 65 years have 1 or more chronic medical problems, and 50% have 2 or more. The cost of care for the elderly is at least 3 to 4 times that of younger populations and is rapidly growing, mostly because of a lack of preventive approaches and overly medicalized and fragmented care. This article summarizes the most up-to-date evidence for specific integrative modalities for common geriatric conditions, including falls, frailty, osteoporosis, and end-of-life palliative care...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28797962/quantitative-trunk-sway-and-prediction-of-incident-falls-in-older-adults
#4
Jeannette R Mahoney, Mooyeon Oh-Park, Emmeline Ayers, Joe Verghese
Poor balance and balance impairments are major predictors of falls. The purpose of the current study was to determine the clinical validity of baseline quantitative static trunk sway measurements in predicting incident falls in a cohort of 287 community-dwelling non-demented older Americans (mean age 76.14±6.82years; 54% female). Trunk sway was measured using the SwayStar™ device, and quantified as angular displacement in degrees in anterior-posterior (pitch) and medio-lateral (roll) planes. Over a one-year follow-up period, 66 elders (23%) reported incident falls...
July 29, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28776468/falls-the-adverse-drug-reaction-of-the-elderly-and-the-impact-of-pharmacogenetics
#5
Katja Susanne Just, Katharina Luise Schneider, Marlen Schurig, Julia Carolin Stingl, Jürgen Brockmöller
Falls is a frequent type of adverse drug reactions causing significant morbidity and mortality in the elderly. We reviewed, with which drugs the risk of falls is relevant and might depend on genomic variation. Pharmacogenetic variability may contribute to drug-induced falls for instance mediated by impaired drug elimination due to inherited deficiency in enzymes like CYP2C9, CYP2C19 and CYP2D6. The relative role of specific genes and polymorphisms in old age may differ from younger people. Biomarkers for frailty, but also genomic biomarkers might help identifying patients at high risk for drug-induced falls...
August 4, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28768325/estimating-risk-of-postsurgical-general-and-geriatric-complications-using-the-vespa-preoperative-tool
#6
Lillian Min, Karen Hall, Emily Finlayson, Michael Englesbe, William Palazzolo, Chiao-Li Chan, Hechuan Hou, Ashley Miller, Kathleen M Diehl
Importance: As greater numbers of older patients seek elective surgery, one approach to preventing postoperative complications is enhanced assessment of risks during preoperative evaluation. Objective: To determine whether a geriatric assessment tool can be implemented in a preoperative clinic and can estimate risk of postoperative complications. Design, Setting, and Participants: In this prospective cohort study, patients 70 years of age or older were assessed in a preoperative clinic for elective surgery from July 9, 2008, to January 5, 2011...
August 2, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28767601/validation-and-reliability-of-falls-risk-for-hospitalized-older-people-frhop-taiwan-version
#7
Yaw-Wen Chang, Ying-Hsue Chang, Yu-Ling Pan, Tung-Wei Kao, Senyeong Kao
A comprehensive fall risk assessment can provide information for effective prevention and intervention measures and reduce falls among hospitalized elderly people. The purpose of this study was to develop a Chinese version of an inpatient fall risk assessment tool and evaluate its validity and reliability.This study employed the Falls Risk for Hospitalised Older People (FRHOP) assessment to construct a FRHOP-Taiwan Version (Tw-FRHOP) through forward, synthesized, and backward translation. A face validation was conducted by 5 clinical nurses and a content validation was conducted by 5 specialists using the content validity index (CVI) to validate the proposed model...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28766081/casual-effects-of-informal-care-and-health-on-falls-and-other-accidents-among-the-elderly-population-in-china
#8
Hong Wu, Naiji Lu, Chenguang Wang, Xinming Tu
PURPOSE: This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g., traffic accidents) among elderly people. We also examine if there are heterogeneous impacts on elderly of different gender, urban status, and past accident history. METHODS: To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts...
August 1, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28762840/prevention-in-the-elderly-a-necessary-priority-for-general-practitioners
#9
Christos Lionis, Patrik Midlöv
Prevention is viewed as a key issue for general practice, yet there is a lack of evidence regarding general practitioners' interventions in both middle-aged and elderly people. This is despite the fact that recommendations and key indicators for monitoring the use of clinical preventive strategies aimed at these groups are available and that both the World Health Organization and European Commission endorse the importance of interventions for healthy and active ageing. This paper draws on two keynote presentations given at the 2015 autumn meeting of the European General Practice Research Network (EGPRN) in Edirne, Turkey (17-20 October 2015)...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28757332/prediction-of-the-incidence-of-falls-and-deaths-among-elderly-nursing-home-residents-the-senior-study
#10
Fanny Buckinx, Jean-Louis Croisier, Jean-Yves Reginster, Céline Lenaerts, Théo Brunois, Xavier Rygaert, Jean Petermans, Olivier Bruyère
OBJECTIVE: The objective of this study was to evaluate, among nursing home residents, the extent to which the various operational definitions of frailty predict mortality and falls at 1 year. METHODS: We studied 662 participants from the Sample of Elderly Nursing home Individuals: An Observational Research (SENIOR) cohort aged 83.2 ± 8.99 years, including 484 (72.5%) women and living in nursing homes. Among this cohort, 584 and 565 participants, respectively, were monitored over 12 months for mortality assessment and for occurrence of falls (ie, by mean of their medical records)...
July 27, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28752182/the-challenging-surgical-treatment-of-closed-distal-humerus-fractures-in-elderly-and-octogenarian-patients-radiographic-and-functional-outcomes-with-a-minimum-follow-up-of-24%C3%A2-months
#11
Carlo Biz, Silvano Pierluigi Sperotto, Nicola Maschio, Matteo Borella, Claudio Iacobellis, Pietro Ruggieri
INTRODUCTION: The main purpose of this retrospective, non-randomized, case series study was to evaluate the clinical and radiographic outcomes of distal humerus fractures (DHFs) in a consecutive series of elderly patients operatively treated by two surgeons, and second, to identify proper indications for two elderly age ranges and two fracture pattern groups. MATERIALS AND METHODS: From January 2009 to June 2014, 51 patients (pts) underwent open reduction and internal fixation (ORIF) using the locking compression plate (LCP) distal humerus plate (DHP) system at our institution...
July 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28746661/postural-balance-and-functional-independence-of-elderly-people-according-to-gender-and-age-cross-sectional-study
#12
Helen Benincasa Nakagawa, Juliana Rizzatto Ferraresi, Melina Galetti Prata, Marcos Eduardo Scheicher
CONTEXT AND OBJECTIVE: Aging causes changes in men and women. Studies have shown that women have worse postural balance and greater functional dependence than men, but there is no consensus regarding this. The aim of this study was to compare the balance and functional independence of elderly people according to sex and age, and to evaluate the association between postural balance and the number of drugs taken. DESIGN AND SETTING: Cross-sectional at a state university...
May 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28741583/elderly-patients-with-an-atypical-presentation-of-illness-in-the-emergency-department
#13
M R Hofman, F van den Hanenberg, I N Sierevelt, C R Tulner
BACKGROUND: Very little information is available on the prevalence and clinical outcome of elderly patients with atypical presentations of illness in the emergency department. The objective was to determine the prevalence and clinical outcome of elderly patients seen in the emergency department with an atypical presentation. METHODS: A monocentric retrospective observational study on 355 elderly patients presenting to the emergency department. Patients of 80 years and older were included...
July 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28725985/diversity-in-fall-characteristics-hampers-effective-prevention-the-precipitants-the-environment-the-fall-and-the-injury
#14
K M Sanders, K Lim, A L Stuart, A Macleod, D Scott, G C Nicholson, L Busija
Falls among the elderly are common and characteristics may differ between injurious and non-injurious falls. Among 887 older Australian women followed for 1.6 years, 32% fell annually. Only 8.5% resulted in fracture and/or hospital admission. The characteristics of those falls are indistinguishable from those not coming to medical attention. INTRODUCTION: The precipitants and environment of all falls occurring among a large cohort of older Caucasian women were categorised by injury status to determine if the characteristics differed between injurious and non-injurious falls...
July 19, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#15
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28713844/epidemiology-diagnosis-and-management-of-neurogenic-orthostatic-hypotension
#16
Jose-Alberto Palma, Horacio Kaufmann
BACKGROUND: Orthostatic hypotension (OH) is a sustained fall in blood pressure on standing which can cause symptoms of organ hypoperfusion. OH is associated with increased morbidity and mortality and leads to a significant number of hospital admissions particularly in the elderly (233 per 100,000 patients over 75 years of age in the US). OH can be due to volume depletion, blood loss, large varicose veins, medications, or due to defective activation of sympathetic nerves and reduced norepinephrine release upon standing (i...
May 2017: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/28709461/do-public-nursing-home-care-providers-deliver-higher-quality-than-private-providers-evidence-from-sweden
#17
Ulrika Winblad, Paula Blomqvist, Andreas Karlsson
BACKGROUND: Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers...
July 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28699240/the-prevalence-of-peripheral-intravenous-cannulae-and-pattern-of-use-a-point-prevalence-in-a-private-hospital-setting
#18
Kelvin Wong, Alannah Cooper, Janie Brown, Leanne Boyd, Michele Levinson
AIMS AND OBJECTIVES: to determine the prevalence and pattern of use of peripheral intravenous cannula (PIVC) in hospital wards. BACKGROUND: PIVC are commonly used in acute health care to directly access the bloodstream for the administration of medications, intravenous fluids (IVF) and blood products. PIVC are associated with multiple adverse events including hospital acquired bloodstream infection, thrombophlebitis, and pain/discomfort. Administration of IVF is associated with impaired mobility and nocturia which may increase falls risk in the elderly...
July 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28694824/burden-and-correlates-of-falls-among-rural-elders-of-south-india-mobility-and-independent-living-in-elders-study
#19
Pawan Kumar Sharma, Clareann H Bunker, Tushar Singh, Enakshi Ganguly, P Sudhakar Reddy, Anne B Newman, Jane A Cauley
AIM: Falls are an important contributor to loss of function, morbidity, and mortality in elders. Little is known about falls in Indian populations. The objective of this cross-sectional report was to identify the prevalence and correlates of falls in a cohort of 562 rural southern Indian men and women. METHODS: Risk factors included demographics, anthropometrics, self-reported health, medical history, physical function, vision, depression, and lifestyle. Odds ratios were calculated using logistic regression...
2017: Current Gerontology and Geriatrics Research
https://www.readbyqxmd.com/read/28692451/the-value-of-musculoskeletal-ultrasound-in-geriatric-care-and-rehabilitation
#20
Büşra Can, Murat Kara, Özgür Kara, Zekeriya Ülger, Walter Frontera, Levent Özçakar
The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions)...
July 7, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
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