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Acute care for elders

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https://www.readbyqxmd.com/read/28730407/venous-thromboembolism-thrombosis-inflammation-and-immunothrombosis-for-clinicians
#1
REVIEW
Eduardo Vazquez-Garza, Carlos Jerjes-Sanchez, Aline Navarrete, Jorge Joya-Harrison, David Rodriguez
Venous thromboembolism (VTE) is a worldwide disease related with mortality, cardiovascular disability, impaired quality of life and, cause major long-term complications. Clinicians related to the acute and long-term patients care must be involved in the molecular mechanisms of thrombosis. The vessel wall and its inner lining of the endothelium are critical to the maintenance of a patent vasculature. After endothelial disruption, collagen (first line of endothelial defense) and intravascular tissue factor (second line of endothelial defense) are exposed to blood flow, starting the formation of a thrombus...
July 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28724505/readmission-to-hospital-of-medical-patients-a-cohort-study
#2
Mette Gothardt Rasmussen, Pernille Ravn, Stig Molsted, Lise Tarnow, Susanne Rosthøj
INTRODUCTION: The incidence of acute readmissions is higher among elderly medical patients than in the general population. Risk factor identification is needed in order to prevent readmissions. OBJECTIVE: To estimate the incidence of acute readmissions among medical patients ≥65years discharged from departments of internal medicine and to identify risk factors associated with readmissions. MATERIAL AND METHODS: We included patients discharged between 1st of January 2011 and 1st of December 2014 and collected data regarding primary diagnosis and comorbidities...
July 16, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#3
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/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#4
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28709946/frailty-and-sarcopenia-do-not-predict-adverse-events-in-an-elderly-population-undergoing-non-complex-primary-elective-surgery-for-degenerative-conditions-of-the-lumbar-spine
#5
Raphaële Charest-Morin, John Street, Honglin Zhang, Taren Roughead, Tamir Ailon, Michael Boyd, Marcel Dvorak, Brian Kwon, Scott Paquette, Nicolas Dea, Charles G Fisher, Alana M Flexman
BACKGROUND CONTEXT: Sarcopenia measured by normalized total psoas area (NTPA) has been shown to predict mortality and adverse events (AE) in numerous surgical populations. The relationship between sarcopenia and postoperative outcomes after surgery for degenerative spine disease (DSD) has not been investigated. PURPOSE: This study aimed to determine the relationships between sarcopenia, frailty and postoperative adverse events in the elderly DSD population. Secondary objectives were to describe the distribution and predictors of NTPA and to determine the relationship between sarcopenia, frailty and length of stay, discharge to a facility and in-hospital mortality...
July 11, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28707743/workplace-continuing-education-for-nurses-caring-for-hospitalised-older-people
#6
Jennifer Baumbusch, Maureen Shaw, Marie-Eve Leblanc, Mary Kjorven, Jae-Yung Kwon, Lorraine Blackburn, Barb Lawrie, Marilyn Shamatutu, Angela C Wolff
AIMS AND OBJECTIVES: To develop, implement and evaluate a workplace continuing education programme about nursing care of hospitalised older people. BACKGROUND: The healthcare system cannot rely solely upon nurses' prelicensure education to prepare them to meet the evolving needs of hospitalised older patients. Over the past decade, there has been a dramatic rise in the proportion of older people in hospitals, yet many nurses do not have specialised knowledge about the unique care needs of this population...
July 14, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28705211/streptococcal-toxic-shock-syndrome-due-to-streptococcus-dysgalactiae-subspecies-equisimilis-in-breast-cancer-related-lymphedema-a-case-report
#7
Makoto Sumazaki, Fumi Saito, Hideaki Ogata, Miho Yoshida, Yorichika Kubota, Syunsuke Magoshi, Hironori Kaneko
BACKGROUND: Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28703869/early-supported-discharge-services-for-people-with-acute-stroke
#8
REVIEW
Peter Langhorne, Satu Baylan
BACKGROUND: People with stroke conventionally receive a substantial part of their rehabilitation in hospital. Services have now been developed that offer people in hospital an early discharge with rehabilitation at home (early supported discharge: ESD). OBJECTIVES: To establish if, in comparison with conventional care, services that offer people in hospital with stroke a policy of early discharge with rehabilitation provided in the community (ESD) can: 1) accelerate return home, 2) provide equivalent or better patient and carer outcomes, 3) be acceptable satisfactory to patients and carers, and 4) have justifiable resource implications use...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28699240/the-prevalence-of-peripheral-intravenous-cannulae-and-pattern-of-use-a-point-prevalence-in-a-private-hospital-setting
#9
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/28681972/pneumonia-in-the-developing-world-characteristic-features-and-approach-to-management
#10
REVIEW
Stephen J Aston
Community-acquired pneumonia (CAP) is a common cause of morbidity and mortality in adults worldwide, but its epidemiology varies markedly by region. Whilst in high-income countries, the predominant burden of CAP is in the elderly and those with chronic cardiovascular and pulmonary co-morbidity, CAP patients in low-income settings are often of working age and, in sub-Saharan Africa, frequently HIV-positive. Although region-specific aetiological data are limited, they are sufficient to highlight major trends: in high-burden settings, tuberculosis (TB) is a common cause of acute CAP; Gram-negative pathogens such as Klebsiella pneumoniae are regionally important; and HIV-associated opportunistic infections are common but difficult to diagnose...
July 6, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28675566/effects-of-two-different-glutamine-containing-enteral-supplements-on-stool-frequency-and-density-in-elderly-patients-recovering-from-acute-critical-illness
#11
Nobutoshi Fushimi, Munenori Yamada, Hiroki Hachiya, Shun Ito, Takashi Shibuya, Noritsugu Ohashi, Akihiro Mori
AIM: Glutamine has various beneficial functions in the gastrointestinal tract. The present study was designed to investigate the effect of two different glutamine supplements on bowel movement at the start of enteral feeding in elderly inpatients. METHODS: This was a double-blind, prospective, randomized comparison study. A total of 25 patients aged >75 years recovering from a critical illness in a non-intensive care unit and scheduled for tube feeding were recruited...
July 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28673584/parp-inhibitors-in-acute-myeloid-leukaemia-therapy-how-a-synthetic-lethality-approach-can-be-a-valid-therapeutic-alternative
#12
Grigore Aristide Gafencu, Ciprian Ionuț Tomuleasa, Gabriel Ghiaur
Acute myeloid leukaemia (AML) is a malignancy in need of new therapeutic options. The current standard of care chemotherapy, leads to complete remission (CR) in the vast majority of adult patients under the age of 60. In contrast, CR rates in patients over the age of 60 reaches only 40-60%. While achievement of a CR is an important stepping stone in the treatment of AML, the majority of these patients experience relapse and die of their disease without adequate consolidation chemotherapy. Blood and marrow transplantation (BMT) can improve outcome in a select patient with AML but unfortunately, it is not a valid treatment option for the majority of older patients...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28666156/family-support-liaison-in-the-witnessed-resuscitation-a-phenomenology-study
#13
Hadi Hassankhani, Vahid Zamanzade, Azad Rahmani, Hamidreza Haririan, Joanne E Porter
BACKGROUND: Family-witnessed resuscitation remains controversial among clinicians from implementation to practice and there are a number of countries, such as Iran, where that is considered a low priority. OBJECTIVE: To explore the lived experience of resuscitation team members with the presence of the patient's family during resuscitation. DESIGN: The hermeneutic phenomenology. SETTINGS: The emergency departments and critical care units of 6 tertiary hospitals in Tabriz, Iran...
June 13, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28662602/racial-ethnic-disparities-in-disability-outcomes-among-post-acute-home-care-patients
#14
Jo-Ana D Chase, Liming Huang, David Russell, Alexandra Hanlon, Melissa O'Connor, Keith M Robinson, Kathryn H Bowles
OBJECTIVE: To examine activities of daily living (ADL) disability outcomes among racially/ethnically diverse elders receiving home care (HC) after hospitalization. METHOD: We conducted a retrospective cohort analysis of single-agency, 2013-2014 Outcome and Assessment Information Set data from older adults who received post-hospitalization HC ( n = 20,674). We measured overall change in ADL disability by summing the difference of standardized admission and discharge scores from nine individual ADL...
June 1, 2017: Journal of Aging and Health
https://www.readbyqxmd.com/read/28661842/innovative-care-model-to-improve-clinical-quality-and-safety-of-transitional-care-early-outcomes
#15
Brooke Roeper, Eric Beck, Daniel Castillo, J Brent Myers, Brandy Sparkman, Jonathan Cox, Scott Bourn
One in five elderly patients returns to the hospital within 30 days of leaving. These rehospitalizations are a common and costly occurrence. A program developed to address problems in post-acute transitional care seems to be effective in reducing 30-day readmission rates for some Medicare fee-for-service beneficiaries.
June 2017: Managed Care
https://www.readbyqxmd.com/read/28658156/comprehensive-geriatric-care-reduces-acute-perioperative-delirium-in-elderly-patients-with-hip-fractures-a-meta-analysis
#16
REVIEW
Yiyang Wang, Jun Tang, Feiya Zhou, Lei Yang, Jianbin Wu
BACKGROUND: The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. METHODS: We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28642857/healthcare-costs-of-osteoporotic-fracture-in-korea-information-from-the-national-health-insurance-claims-database-2008-2011
#17
Ha Young Kim, Yong-Chan Ha, Tae-Young Kim, Hyemin Cho, Young-Kyun Lee, Ji-Yeon Baek, Sunmee Jang
BACKGROUND: The present study estimated healthcare costs of osteoporotic fractures including spine, hip, distal radius and humerus in Koreans over 50 years of age using national claims data. METHODS: Korea National Health Insurance data between 2008 and 2011 was searched for all claims records of outpatient visits or hospital admissions of patients ≥50-year-of-age. Osteoporosis-related fractures were identified using certain the International Classification of Diseases, Tenth Revision codes and site-specific physician claims for procedures in a patient age cut-off value of 50 years...
May 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#18
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28626858/antibiotics-for-acute-bronchitis
#19
REVIEW
Susan M Smith, Tom Fahey, John Smucny, Lorne A Becker
BACKGROUND: The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. OBJECTIVES: To assess the effects of antibiotics in improving outcomes and to assess adverse effects of antibiotic therapy for people with a clinical diagnosis of acute bronchitis. SEARCH METHODS: We searched CENTRAL 2016, Issue 11 (accessed 13 January 2017), MEDLINE (1966 to January week 1, 2017), Embase (1974 to 13 January 2017), and LILACS (1982 to 13 January 2017)...
June 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#20
Fannie Santoni, Valéry Antoine, Alberto di Castri, Maurice Viala, Laetitia Geronimi-Robelin, Cédric LeGuillou, Christine de Taddeo, Sophie Bastide, Claude Jeandel, Benoit de Wazieres
Polypharmacy, potentially inappropriate prescriptions and inadequate coordination between prescribers are among main factors explaining the occurrence of adverse drug events in elderly patients. Prospective and descriptive study of medication prescriptions for elderly patients during a continuous period of health-care: entry in an acute geriatric unit (T1), at discharge (T2) and two months after hospitalization (T3). A global iatrogenic risk was defined: presence of poly-pharmacy and/or PPI (Laroche criteria) and/or absence of quality indicators for prescription according to the French health authority...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
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