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Acute care for elders

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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28625262/-predictive-value-of-sofa-score-combined-agi-grading-system-in-elderly-patients-with-sepsis-a-retrospective-analysis-with-91-patients
#4
Lingling Wang, Rui Chen, Zexun Mo, Jiahui Dong, Zhaokun Sun, Fei Xiao, Shaoting Hu, Richeng Xiong, Jie Sun, Zhou Yu, Zhenhui Guo
OBJECTIVE: To explore the predictive value of sequential organ failure assessment (SOFA) score combined the acute gastrointestinal injury (AGI) grading system in critical elderly patients with sepsis. METHODS: A retrospective analysis was conducted. Elderly patients with sepsis aged > 60 years admitted to medical intensive care unit (MICU) of General Hospital of Guangzhou Military Command from March 2014 to December 2015 and experiencing critical care over 48 hours were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#5
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28612615/-new-drugs-in-the-treatment-of-acute-myeloid-leukemia-in-the-elderly
#6
Z Šustková, M Čulen, L Semerád, I Ježíšková, D Dvořáková, Z Ráčil, J Mayer
BACKGROUND: At the time of diagnosis, most patients with acute myeloid leukemia are older than 65 years of age. Treatment of this group of patients is challenging because they become less tolerant to aggressive chemotherapy with increasing age. Less than one-third of elderly patients are considered eligible for intensive treatment; nevertheless, the survival analysis for this population remains poor. Due to numerous comorbidities and an overall deteriorating condition, most elderly patients with acute myeloid leukemia receive only palliative or best supportive care, which are associated with a high mortality rate...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28600113/non-typhi-salmonella-enterica-urinary-tract-infections
#7
G Mellon, C Delanoe, A L Roux, B Heym, O Dubourg, P Hardy, B Chevallier, C Perronne, E Rouveix, J Salomon
OBJECTIVE: Non-typhi Salmonella enterica urinary tract infections (UTIs) are not frequent and rarely reported in the literature. We aimed to characterize clinical presentations and risk factors for the infection. PATIENTS AND METHODS: We performed a retrospective study of non-typhi Salmonella enterica strains isolated from urine cytobacteriological examinations (UCBE) collected between January 1, 1996 and October 30, 2014 and analyzed by the microbiology laboratories of the university hospitals of the western part of Île-de-France and of Paris, France...
June 6, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28595684/marijuana-use-in-the-elderly-implications-and-considerations
#8
Tracy D Mahvan, Michelle L Hilaire, Allison Mann, Antoinette Brown, Becky Linn, Taylor Gardner, Beryen Lai
OBJECTIVE: This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. DATA SOURCES: PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology...
June 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28595583/the-association-between-number-of-doctors-per-bed-and-readmission-of-elderly-patients-with-pneumonia-in-south-korea
#9
Joo Eun Lee, Tae Hyun Kim, Kyoung Hee Cho, Kyu-Tae Han, Eun-Cheol Park
BACKGROUND: There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. METHODS: We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013...
June 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28594497/arthroplasty-for-unreconstructable-acute-fractures-and-failed-fracture-fixation-about-the-hip-and-knee-in-the-active-elderly-a-new-paradigm
#10
Richard F Kyle, Paul J Duwelius, George J Haidukewych, Andrew H Schmidt
The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594057/online-interventions-for-caregivers-of-people-with-dementia-a-systematic-review
#11
Esther Parra-Vidales, Felipe Soto-Pérez, Mª Victoria Perea-Bartolomé, Manuel A Franco-Martín, Juan L Muñoz-Sánchez
INTRODUCTION: The elderly population is growing driven by the increase in life expectancy, which in turn entails an increase in the number of people with chronic diseases such as dementia. The vast majority of people suffering from this illness is assisted by informal caregivers, who play a key role in fulfilling the patients’ needs, promoting the possibility for people with dementia to live in their home environment. The Internet as a support tool in psychoeducational programs can significantly improve accessibility of them, becoming a currently consolidated interactive resource for the training of patients with acute and chronic diseases, and their caregivers...
May 2017: Actas Españolas de Psiquiatría
https://www.readbyqxmd.com/read/28587716/-predictive-factors-of-functional-decline-at-hospital-discharge-in-elderly-patients-hospitalised-due-to-acute-illness
#12
Patricia Ysabel Condorhuamán-Alvarado, Rocío Menéndez-Colino, Coro Mauleón-Ladrero, Jesús Díez-Sebastián, Teresa Alarcón, Juan Ignacio González-Montalvo
OBJECTIVE: To compare baseline characteristics and those found during hospitalisation as predictors of functional decline at discharge (FDd) in elderly patients hospitalised due to acute illness. MATERIAL AND METHOD: A review was made of the computerized records of patients admitted to a Geriatric Acute Unit of a tertiary hospital over a 10 year period. A record was made of demographic, clinical, functional and health-care variables. Functional decline at discharge (FDd) was defined by the difference between the previous Barthel Index (pBI) and the discharge Barthel Index (dBI)...
June 3, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28573820/aromatherapy-massage-versus-reflexology-on-female-elderly-with-acute-coronary-syndrome
#13
Tahereh Bahrami, Nahid Rejeh, Majideh Heravi-Karimooi, Mojtaba Vaismoradi, Seyed Davood Tadrisi, Christina L Sieloff
BACKGROUND: Fatigue and abnormalities in cardiovascular parameters are recognized as major problems for patients with acute coronary syndrome. Non-pharmacological nursing interventions are useful for controlling this fatigue and reducing patients' suffering during hospitalization. AIM: The present study compared the effects of aromatherapy massage and reflexology on fatigue and cardiovascular parameters in older female patients with acute coronary syndrome. DESIGN: This study was a randomized clinical trial...
June 2, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28567524/patterns-of-care-and-survival-for-elderly-acute-myeloid-leukemia-challenges-and-opportunities
#14
REVIEW
Abhishek A Mangaonkar, Mrinal M Patnaik
PURPOSE OF REVIEW: Acute myeloid leukemia (AML) is a disease of the elderly, with a median age of diagnosis in the sixth decade of life. Mortality has declined over the last few years, but this impact is apparent only in the young, fit AML population. Outcomes for the elderly remain poor, with less than 20% 5-year overall survival rates. Hence, there is an unmet need to identify treatment strategies to maximize benefit in this age group. RECENT FINDINGS: Elderly AML is a difficult entity to treat due to both disease and patient-related factors...
May 31, 2017: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/28567160/the-introduction-of-a-multidisciplinary-hip-fracture-pathway-to-optimise-patient-care-and-reduce-mortality-a-prospective-audit-of-161-patients
#15
Michael Shenouda, Zacharia Silk, Sarkhell Radha, Emer Bouanem, Warwick Radford
INTRODUCTION: Hip fractures are a major cause of morbidity and mortality in the elderly. A new patient pathway was introduced in our institution to facilitate rapid preoperative assessment, acute physician involvement and early surgery for patients with hip fractures. We sought to assess its impact on patient care and outcomes. MATERIALS AND METHODS: Prospective audit of 161 patients admitted with a proximal femoral fracture in the six months before (92 patients) and after (69 patients) implementation of the pathway...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28558083/obesity-and-its-association-with-food-consumption-diabetes-mellitus-and-acute-myocardial-infarction-in-the-elderly
#16
Erika Aparecida da Silveira, Liana Lima Vieira, Thiago Veiga Jardim, Jacqueline Danesio de Souza
BACKGROUND: Obesity affects a large part of elderly individuals worldwide and is considered a risk predictor for the development of chronic diseases such as cardiac diseases, the leading causes of death in the elderly population. OBJECTIVE: To investigate the prevalence of obesity and associated factors, with emphasis on the occurrence of other diseases and on food consumption in elderly individuals treated at the Brazilian Unified Health System (Sistema Único de Saúde, SUS)...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28553792/adherence-to-guidelines-for-screening-and-medication-use
#17
Arseniy P Yashkin, Frank Sloan
OBJECTIVE: The objective of this study is to investigate relationships between adherence to recommended screening and medication use and severe macrovascular complications and all-cause mortality among persons aged above 68 years with diabetes mellitus (DM). METHOD: Data came from a 5% Medicare claims sample of beneficiaries initially diagnosed with DM during 2006-2008; follow-up was up to 7 years. RESULTS: Adherence to screening guidelines led to reduced mortality-hazard ratio (HR) = 0...
December 1, 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/28551043/improving-transitions-to-post-acute-care-for-elderly-patients-using-a-novel-video-conferencing-program-echo-care-transitions
#18
Amber B Moore, J Elyse Krupp, Alyssa B Dufour, Mousumi Sircar, Thomas G Travison, Alan Abrams, Grace Farris, Melissa L P Mattison, Lewis A Lipsitz
PURPOSE: Within 30 days of hospital discharge to a skilled nursing facility, older adults are at high risk for death, re-hospitalization and high-cost healthcare. The purpose of this study was to examine whether a novel videoconference program called Extension for Community Health Outcomes-Care Transitions (ECHO-CT) that connects an interdisciplinary hospital-based team with clinicians at skilled nursing facilities, reduces patient mortality, hospital readmission, skilled nursing facility length of stay and 30-day health care costs...
May 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28550693/healthcare-for-the-aging-citizen-and-the-aging-citizen-for-healthcare-involving-patient-advisors-in%C3%A2-elder-friendly-care-improvement
#19
Jennifer Verma, Patricia O'Connor, Jerold Hodge, Howard Abrams, Jocelyn Bennett, Samir Sinha
With an aging population and a healthcare system that is overly reliant on providing expensive and sometimes problematic hospital-based care for older Canadians, driving improvements that promote elder-friendly care has never been more critical. The Acute Care for Elders (ACE) Strategy at Toronto's Mount Sinai Hospital is the focus of a pan-Canadian collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with the Canadian Frailty Network. The intent is to spread the ACE Strategy's elder-friendly models of care and practices to 18 participating healthcare delivery organizations...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28540115/the-benefits-of-streamlined-hip-fracture-management-in-a-regional-hospital
#20
T C Mow, Jen Lukeis, A G Sutherland
INTRODUCTION: Hip fracture is an increasingly common injury in the growing elderly population. The morbidity and mortality associated with this injury can be reduced by minimizing delays to surgical treatment. We describe the impact of a regional hospital service redesign project that utilized the principles of smart simplicity, a management strategy that lays emphasis on collaboration to achieve desired goals. METHODS: Prior to the redesign, patients with hip fractures were taking an average of 72 hours for surgical treatment...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
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