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Geriatric care management

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https://www.readbyqxmd.com/read/28544166/clinical-features-of-extremely-elderly-patients-with-heart-failure
#1
Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Takamasa Sato, Satoshi Suzuki, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
AIM: To investigate the clinical features of heart failure in extremely elderly patients. METHODS: We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years-of-age, n = 88) and a non-extremely elderly group (<85 years-of-age, n = 1075). RESULTS: The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β-blockers and anticoagulants compared with the non-extremely elderly group...
May 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28540117/orthogeriatric-combined-management-of-elderly-patients-with-proximal-femoral-fracture-results-of-a-1-year-follow-up
#2
Stefan Förch, Reiner Kretschmer, Thomas Haufe, Johannes Plath, Edgar Mayr
INTRODUCTION: According to the expected demographical changes, the number of elderly trauma patients will increase exponentially over the next decades. Different models of an interdisciplinary orthogeriatric care have been developed. But there is only limited evaluation of their benefit without clear and evidence-based results. In 2011, we monitored the results of our orthogeriatric combined management by conducting a 1-year follow-up. METHODS: We treated 231 patients presenting a proximal femoral fracture on our orthogeriatric ward...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#3
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28537333/changes-in-nutritional-and-functional-status-in-longer-stay-patients-admitted-to-a-geriatric-evaluation-and-management-unit
#4
A Whitley, E Skliros, C Graven, R McIntosh, C Lasry, C Newsome, A Bowie
OBJECTIVES: Malnutrition and functional decline are common in older inpatients admitted to subacute care settings. However the association between changes in nutritional status and relevant functional outcomes remains under-researched. This study examined changes in nutritional status, function and mobility in patients admitted to a Geriatric Evaluation and Management (GEM) unit who had a length of stay (LOS) longer than 21 days. DESIGN: A prospective, observational study...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28537060/comprehensive-approach-for-managing-the-older-person-with-diabetes-mellitus
#5
REVIEW
Hyung Joon Yoo
Care of the elderly population with diabetes may not be restricted to the management of hyperglycemia, associated risk factors, and specific diabetic complications. An integrated approach should also include the assessment and management of gerontological problems. Both diabetes mellitus and aging interact toward the direction of the increased incidence of geriatric syndromes. Education is a common element of both diabetes control and geriatric syndrome care. However, it has been perceived that conventional education programs for diabetics are not as effective for the elderly...
May 18, 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/28534471/management-of-acetabular-fractures-in-the-geriatric-patient
#6
Marc Hanschen, Sebastian Pesch, Stefan Huber-Wagner, Peter Biberthaler
INTRODUCTION: Open reduction and internal fixation (ORIF) is standard care for most acetabular fractures. With increasing numbers of acetabular fractures in the elderly, the risk of revision surgery and conversion to total hip replacement (THR) is increasing. Alarmingly, about 20-25% of acetabular fractures in the elderly following ORIF needed revision and conversion to delayed THR. METHODS: Recently, prognostic factors have been identified, which correlate with an increased risk of worse outcomes following ORIF of acetabular fractures in the elderly patient...
2017: SICOT-J
https://www.readbyqxmd.com/read/28531254/frailty-status-at-admission-to-hospital-predicts-multiple-adverse-outcomes
#7
Ruth E Hubbard, Nancye M Peel, Mayukh Samanta, Leonard C Gray, Arnold Mitnitski, Kenneth Rockwood
Aims: frailty is proposed as a summative measure of health status and marker of individual vulnerability. We aimed to investigate the discriminative capacity of a frailty index (FI) derived from interRAI Comprehensive Geriatric Assessment for Acute Care (AC) in relation to multiple adverse inpatient outcomes. Methods: in this prospective cohort study, an FI was derived for 1,418 patients ≥70 years across 11 hospitals in Australia. The interRAI-AC was administered at admission and discharge by trained nurses, who also screened patients daily for geriatric syndromes...
May 22, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28529911/severe-trauma-in-the-geriatric-population
#8
REVIEW
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Mario Chico-Fernández, Marcelino Sánchez-Casado, Joan Maria Raurich
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28526493/improving-comfort-around-dying-in-elderly-people-a-cluster-randomised-controlled-trial
#9
Kim Beernaert, Tinne Smets, Joachim Cohen, Rebecca Verhofstede, Massimo Costantini, Kim Eecloo, Nele Van Den Noortgate, Luc Deliens
BACKGROUND: Over 50% of elderly people die in acute hospital settings, where the quality of end-of-life care is often suboptimum. We aimed to assess the effectiveness of the Care Programme for the Last Days of Life (CAREFuL) at improving comfort and quality of care in the dying phase in elderly people. METHODS: We did a cluster randomised controlled trial in acute geriatric wards in ten hospitals in Flemish Region, Belgium, between Oct 1, 2012, and March 31, 2015...
May 16, 2017: Lancet
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#10
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28498197/overuse-of-health-care-services-in-the-management-of-cancer-a-systematic-review
#11
Shrujal S Baxi, Minal Kale, Salomeh Keyhani, Benjamin R Roman, Annie Yang, Antonio P Derosa, Deborah Korenstein
BACKGROUND: Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. METHODS: We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and 2 grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation's Choosing Wisely initiative in 2012...
May 11, 2017: Medical Care
https://www.readbyqxmd.com/read/28495660/geriatric-patient-safety-indicators-based-on-linked-administrative-health-data-to-assess-anticoagulant-related-thromboembolic-and-hemorrhagic-adverse-events-in-older-inpatients-a-study-proposal
#12
Marie-Annick Le Pogam, Catherine Quantin, Oliver Reich, Philippe Tuppin, Anne Fagot-Campagna, Fred Paccaud, Isabelle Peytremann-Bridevaux, Bernard Burnand
BACKGROUND: Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide...
May 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#13
Mary E Anderson, Kelly Mcdevitt, Ethan Cumbler, Heather Bennett, Zachary Robison, Bryan Gomez, Jason W Stoneback
CONTEXT: Fragmentation in geriatric hip fracture care is a growing concern because of the aging population. Patients with hip fractures at our institution historically were admitted to multiple different services and units, leading to unnecessary variation in inpatient care. Such inconsistency contributed to delays in surgery, discharge, and functional recovery; hospital-acquired complications; failure to adhere to best practices in osteoporosis management; and poor coordination with outpatient practitioners...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488559/-hip-fracture-in-elderly-patients-additional-value-of-a-multidisciplinary-approach-and-concentration-of-care
#14
P van der Vet, J Kussen, M van Dijk, R M Houwert, E J M M Verleisdonk, D van der Velde
Management of elderly patients with a proximal femoral fracture is an increasing challenge for the Dutch healthcare system. Proximal femoral fractures in the elderly have high morbidity and mortality rates. Furthermore, healthcare costs for this group of patients are rising. Referral, operation and postoperative care demand efficient collaboration between healthcare professionals. Every step in this chain of events is crucial for optimal treatment results. Multidisciplinary orthogeriatric trauma care shows promising results...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28487749/highlights-from-the-first-ecancer-liga-colombiana-contra-el-cancer-conference-17-18-november-2016-bogota-colombia
#15
Carlos Castro
The first oncology conference organised by ecancer and the Liga Colombiana contra el Cancer took place on 17-18 November 2016 in Bogota. It was a highly successful event owing to the number of participants, the quality of the speakers, and the academic programme. Around 48 professors from 8 different countries came and shared their knowledge and experience of cancer management. They also talked about the most recent developments noted or achieved in this area. The keynote speech from Dr Nubia Muñoz was of great interest which was related to the safety of a HPV vaccine and the implications of a mass vaccination programme in developing countries...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28485039/is-geriatric-medicine-possible-in-a-middle-income-country-the-case-of-costa-rica
#16
Fernando Morales-Martínez
This article outlines the current and future-projected demographic data, organization, networks for the care of older people, and perspectives in Costa Rica in relation to the challenges resulting from exponential growth of the older adult population, most notably those aged 80 and older. It includes consideration of the Norms of Integrated Care of the Older Adult of Costa Rica's national social security system and contributions from other public and private institutions. It also makes note of commentaries on the need for ever-increasing efforts to manage the care of Costa Rica's burgeoning older adult population...
May 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28471943/clinical-implications-of-aging-with-hiv-infection-perspectives-and-the-future-medical-care-agenda
#17
Giovanni Guaraldi, Frank J Palella
: The increasing number of aging HIV-infected (HIV+) persons comprises a unique population at risk for illnesses and syndromes traditionally associated with the elderly. As a result, similar to the current need for primary care providers to manage chronic noninfectious comorbidities among aging persons with well controlled HIV infection, HIV clinical care will need to routinely involve geriatric medicine in a new HIV-geriatric discipline. The objective of this article is to provide a conceptual framework in which HIV and geriatric management considerations for healthcare professionals caring for HIV+ persons are integrated...
June 1, 2017: AIDS
https://www.readbyqxmd.com/read/28471238/clinician-perceptions-about-inpatient-occupational-therapy-groups-in-traumatic-brain-injury-rehabilitation
#18
Freyr Patterson, Jennifer Fleming, Emmah Doig
PRIMARY OBJECTIVE: The aim of the study was to explore the experiences and perceptions of clinicians about the benefits, challenges and processes of facilitating inpatient occupational therapy groups in traumatic brain injury (TBI) rehabilitation including peer-to-peer interactions and use of goals. DESIGN AND METHOD: A qualitative methodology, guided by a phenomenological approach was utilized with data collected from focus groups comprising 26 clinicians working in occupational therapy in three inpatient rehabilitation settings: brain injury, spinal injury and geriatric rehabilitation in order to identify aspects unique to brain injury rehabilitation...
May 4, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28467006/initiating-activities-of-daily-living-contributes-to-well-being-in-people-with-dementia-and-their-carers
#19
Clarissa M Giebel, Caroline Sutcliffe
OBJECTIVE: Problems with everyday functioning are linked to reduced well-being in people with dementia (PwD) and their carers. However, previous research has almost solely investigated the performance of everyday activities, and global functioning without analysing individual activities. This study explored how deficits in initiating and performing individual activities were associated with carer burden and poorer quality of life of carers and PwD. METHODS: Carers of people with mild dementia were recruited via 10 National Health Service Trusts, as well as through attending six carer support groups...
May 3, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28465007/a-comparison-of-treatment-setting-for-elderly-patients-with-hip-fracture-is-the-geriatric-ward-superior-to-conventional-orthopedic-hospitalization
#20
Tal Frenkel Rutenberg, Efrat Daglan, Snir Heller, Steven Velkes
INTRODUCTION: Hip fractures in the elderly are a major cause of morbidity and mortality. The treatment settings of these patients may change their outcomes. The aim of this study is to compare the outcomes of patients with displaced femoral neck fractures who were admitted to the orthopedic vs. geriatric wards. PATIENTS AND METHODS: A retrospective study was conducted on 217 consecutive older patients with 219 displaced femoral neck fractures admitted either to the orthopedic or the geriatric ward between Jan...
April 25, 2017: Injury
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