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Acute care for elders

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https://www.readbyqxmd.com/read/28237047/percutaneous-cholecystostomy-in-the-management-of-high-risk-patients-presenting-with-acute-cholecystitis-timing-and-outcome-at-a-single-institution
#1
S Zarour, A Imam, G Kouniavsky, G Lin, A Zbar, E Mavor
BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28228902/mri-diagnosis-of-herpes-simplex-encephalitis-in-an-elderly-man-with-nonspecific-symptoms
#2
Benjamin J Croll, Zachary M Dillon, Kevin R Weaver, Marna Rayl Greenberg
A 78-year-old male presented to the Emergency Department complaining of a 1-week onset of increasing fatigue and anorexia. The patient was previously well but had a history of depression, chronic diarrhea, and hypertension. His examination was remarkable for mild fever (100.1°F). He had no acute neurologic deficits. The patient felt better after intravenous fluids and was discharged to follow-up with the primary care provider. With no resolution of symptoms and new memory loss, the patient's primary care doctor ordered an MRI which revealed abnormal signal/patchy enhancement of the left temporal lobe indicative (pathognomonic) of herpes simplex encephalitis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28216064/internal-fixation-of-acetabular-fractures-in-an-older-population-using-the-timi-approach-midterm-results-of-a-prospective-study
#3
Rene Aigner, Ralf Hellige, Sabine Knippel, Ludwig Oberkircher, Steffen Ruchholtz, Benjamin Buecking
INTRODUCTION: The incidence of geriatric acetabular fractures continues to increase due to demographic changes. In the elderly, anterior column fractures are common, and standard approaches are associated with a considerable risk for surgery-associated complications. Therefore, a minimally invasive approach was developed in our department. The aim of this study was to examine early and mid-term results regarding the use of this novel two-incision minimally invasive (TIMI) approach in patients aged over 55 years with acetabular fractures...
February 3, 2017: Injury
https://www.readbyqxmd.com/read/28210101/acute-kidney-injury-in-elderly-intensive-care-patients-from-a-developing-country-clinical-features-and-outcome
#4
Laís Gabriela Yokota, Beatriz Motta Sampaio, Erica Rocha, André Luís Balbi, Daniela Ponce
AIM: The elderly are at high risk of acute kidney injury (AKI) because of structural and functional degeneration over time and with the aging of the population, the demand for intensive care unit (ICU) admission for older patients has risen recently. However, data from developing countries are scarce. This study aimed to describe the incidence of AKI in elderly patients admitted to ICU from a developing country, to determine the most frequent etiologies for renal impairment and identify its risk factors and outcome...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28205241/septic-transfusion-case-caused-by-a-platelet-pool-with-visible-clotting-due-to-contamination-with-staphylococcus-aureus
#5
Maria Loza-Correa, Yuntong Kou, Mariam Taha, Miloslav Kalab, Jennifer Ronholm, Patrick M Schlievert, Michael P Cahill, Robert Skeate, Christine Cserti-Gazdewich, Sandra Ramirez-Arcos
BACKGROUND: Contamination of platelet concentrates (PCs) with Staphylococcus aureus is one of the most significant ongoing transfusion safety risks in developed countries. CASE REPORT: This report describes a transfusion reaction in an elderly patient diagnosed with acute myeloid leukemia, transfused with a 4-day-old buffy coat PC through a central venous catheter. The transfusion was interrupted when a large fibrous clot in the PC obstructed infusion pump flow...
February 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28184303/deprescribing-medicines-in-the-acute-setting-to-reduce-the-risk-of-falls
#6
Vanessa Marvin, Emily Ward, Alan J Poots, Katie Heard, Arvind Rajagopalan, Barry Jubraj
BACKGROUND: Falls are a common cause of morbidity and hospitalisation in older people. Inappropriate prescribing and polypharmacy contribute to falls risk in elderly patients. This study's aim was to quantify the problem and find out if medication review in the hospital setting led to deprescribing of medicines associated with falls risk. METHODS: Admissions records for elderly patients were examined to identify those whose presenting complaint included a fall. Inpatient medication charts, pharmaceutical care notes, medical notes and discharge summaries were examined to identify any falls-risk medicines from admission histories and to determine if any medication review took place, and whether or not changes were made as a result...
January 2017: European Journal of Hospital Pharmacy. Science and Practice
https://www.readbyqxmd.com/read/28178122/mortality-after-portal-vein-embolization-two-case-reports
#7
Eung Chang Lee, Sang-Jae Park, Sung-Sik Han, Hyeong Min Park, Seung Duk Lee, Seong Hoon Kim, In Joon Lee, Hyun Beom Kim
Portal vein embolization (PVE) is increasingly performed worldwide to reduce the possibility of liver failure after extended hepatectomy, by inducing future liver remnant (FLR) hypertrophy and atrophy of the liver planned for resection. The procedure is known to be very safe and to have few procedure-related complications.In this study, we described 2 elderly patients with Bismuth-Corlette type IV Klatskin tumor who underwent right trisectional PVE involving the embolization of the right portal vein, the left medial sectional portal branch, and caudate portal vein...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28164253/heart-failure-in-the-elderly-ten-peculiar-management-considerations
#8
Feras Bader, Bassam Atallah, Lisa F Brennan, Rola H Rimawi, Mohammed E Khalil
Chronic heart failure (HF) is a disease with significantly higher prevalence in the elderly or patients older than 65 years old. Typically, older patients have more risk factors for HF, more comorbidities, and are more likely to have recurrent admissions for acute decompensations. With HF burden on health care systems primarily related to hospital and nursing home costs, it is critical that elderly patients are approached with a clear understanding of certain unique clinical, laboratory, imaging, and pharmacokinetic differences that can alter their management and outcomes...
February 6, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28164113/nonpharmacological-interventions-targeted-at-delirium-risk-factors-delivered-by-trained-volunteers-medical-and-psychology-students-reduced-need-for-antipsychotic-medications-and-the-length-of-hospital-stay-in-aged-patients-admitted-to-an-acute-internal-medicine
#9
Stanislaw Gorski, Karolina Piotrowicz, Krzysztof Rewiuk, Monika Halicka, Weronika Kalwak, Paulina Rybak, Tomasz Grodzicki
Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28149026/validation-of-a-prognostic-score-for-mortality-in-elderly-patients-admitted-to-intensive-care-unit
#10
Luis Alejandro Sánchez-Hurtado, Adrian Ángeles-Veléz, Brigette Carmen Tejeda-Huezo, Juan Carlos García-Cruz, Teresa Juárez-Cedillo
CONTEXT: The performance of a prognostic score must be evaluated prior to being used. The aim of the present study was to evaluate the predictive ability of hospital mortality of Simplified Acute Physiology Score 3 (SAPS 3) score in elderly patients admitted to Intensive Care Units (ICUs). AIMS: The aim of the present study was to evaluate the SAPS 3 score predictive ability of hospital mortality in elderly patients admitted to ICU. SETTINGS AND DESIGN: This study was conducted as a prospective cohort, in two mixed ICUs...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28144802/treatment-of-elderly-patients-with-acute-myeloid-leukemia
#11
REVIEW
Xavier Thomas, Caroline Le Jeune
There is no standard of care for older patients with acute myeloid leukemia (AML) unfit for intensive chemotherapy. AML in older patients remains an area of significant unmet need necessitating novel therapeutic strategies. In older patients with normal cytogenetics, molecular variables can be helpful in refining risk. This molecular revolution has promoted a shift in the treatment paradigm of AML. Open new questions concern the necessity of an individualized therapy that may take into account not only an increase in survival but also the maintenance or improvement in terms of quality of life, the management of symptoms, and a maximization of time outside of hospital care...
January 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28133044/-an-examination-of-colon-cancer-treatment-policies-for-the-elderly
#12
Hirofumi Hasegawa, Shigeru Ueda, Tomonori Nakanoko, Tomonobu Gion, Masayuki Kitamura
Currently, the rate of aging is increasing rapidly and the number of elderly patients in hospitals is rising in Japan. Under such circumstances, we established an emergency care unit for the elderly at our hospital in July 2014 to provide acute healthcare of the community. Our unit has been active in providing treatment for acute diseases in elderly individuals in the community. We are also pursuing continuous medical care for elderly individuals in collaboration with the community comprehensive care unit at our hospital and other facilities in the community, such as care facilities for the elderly and specialist elderly nursing homes...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#13
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28104597/preferences-about-information-and-decision-making-among-older-patients-with-and-without-cancer
#14
Elena Paillaud, Florence Canoui-Poitrine, Gwenaelle Varnier, Narges Anfasi-Ebadi, Ester Guery, Olivier Saint-Jean, Mathilde Gisselbrecht, Thomas Aparicio, Sylvie Bastuji-Garin, Marie Laurent, Philippe Caillet
BACKGROUND: information of older patients with cancer is crucial to ensure optimal care. OBJECTIVES: to compare older patients with and without cancer regarding their preferences about medical information, decision-making and surrogate designation. DESIGN: an intention-to-act questionnaire was completed by patients ≥70 y enroled in the ELderly CAncer PAtients cohort between January and June 2013 and by patients in the same age group enroled in a cross-sectional survey conducted in 2005 in acute geriatric wards...
January 18, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28101555/predictors-for-living-at-home-after-geriatric-inpatient-rehabilitation-a-prospective-cohort-study
#15
Jan Kool, Peter Oesch, Stefan Bachmann
OBJECTIVE: To evaluate patient characteristics predicting living at home after geriatric rehabilitation. DESIGN: Prospective cohort study. PATIENTS: A total of 210 patients aged 65 years or older receiving inpatient rehabilitation. METHODS: Candidate predictors evaluated during rehabilitation were: age, vulnerability (Vulnerable Elders Survey), multimorbidity (Cumulative Illness Rating Scale), cognition (Mini-Mental State Examination), depression (Hospital Anxiety and Depression Scale), living alone, previous independence in activities of daily living, fall risk, and mobility at discharge (Timed Up and Go test)...
January 31, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28095385/early-cholecystectomy-for-acute-cholecystitis-in-the-elderly-population-a-systematic-review-and-meta-analysis
#16
Charlotte S Loozen, Bert van Ramshorst, Hjalmar C van Santvoort, Djamila Boerma
BACKGROUND: In the era of advanced surgical techniques and improved perioperative care, the willingness to perform emergency operations in elderly patients continues to increase. This systematic review aimed at assessing the clinical outcomes of early cholecystectomy in elderly patients with acute cholecystitis. METHODS: Medline, Embase, and Cochrane Library databases were systematically searched for studies reporting on early cholecystectomy for acute cholecystitis in patients aged ≥70 years...
January 18, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28093379/the-epital-care-model-a-new-person-centered-model-of-technology-enabled-integrated-care-for-people-with-long-term-conditions
#17
Klaus Phanareth, Søren Vingtoft, Anders Skovbo Christensen, Jakob Sylvest Nielsen, Jørgen Svenstrup, Gro Karine Rosvold Berntsen, Stanton Peter Newman, Lars Kayser
BACKGROUND: There is worldwide recognition that the future provision of health care requires a reorganization of provision of care, with increased empowerment and engagement of patients, along with skilled health professionals delivering services that are coordinated across sectors and organizations that provide health care. Technology may be a way to enable the creation of a coherent, cocreative, person-centered method to provide health care for individuals with one or more long-term conditions (LTCs)...
January 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28088181/acute-and-chronic-kidney-disease-in-elderly-patients-with-hip-fracture-prevalence-risk-factors-and-outcome-with-development-and-validation-of-a-risk-prediction-model-for-acute-kidney-injury
#18
Christine J Porter, Iain K Moppett, Irene Juurlink, Jessica Nightingale, Christopher G Moran, Mark A J Devonald
BACKGROUND: Hip fracture is a common injury in older people with a high rate of postoperative morbidity and mortality. This patient group is also at high risk of acute kidney injury (AKI) and chronic kidney disease (CKD), but little is known of the impact of kidney disease on outcome following hip fracture. METHODS: An observational cohort of consecutive patients with hip fracture in a large UK secondary care hospital. Predictive modelling of outcomes using development and validation datasets...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#19
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28074746/oncology-s-trojan-horse-using-viruses-to-battle-cancer
#20
Heena J Mavani, Jeannette Y Wick
: In 2016, the American health care system was faced with more than 1.6 million new cases of cancer, and individuals older than 65 years of age will be affected disproportionately. Many older individuals are poor candidates for traditional treatments (e.g., chemotherapy, radiation) because of actual or potential treatment-related adverse events. Researchers continuously look for novel therapeutic strategies, and an exciting new one is on the horizon: virotherapy. Viruses' ability to infect and kill human cells makes them promising cancer treatments...
December 1, 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
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