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https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#1
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/29032788/using-the-bergman-paris-question-to-screen-seniors-in-the-emergency-department
#2
Antoine Lague, Philippe Voyer, Marie-Christine Ouellet, Vale Rie Boucher, Marianne Giroux, Mathieu Pelletier, E Milie Gouin, Raoul Daoust, Simon Berthelot, Miche le Morin, Thien Tuong Minh Vu, Jacques Lee, Audrey-Anne Brousseau, Marie-Jose E Sirois, Marcel E Mond
OBJECTIVES: In the fast pace of the Emergency Department (ED), clinicians are in need of tailored screening tools to detect seniors who are at risk of adverse outcomes. We aimed to explore the usefulness of the Bergman-Paris Question (BPQ) to expose potential undetected geriatric syndromes in community-living seniors presenting to the ED. METHODS: This is a planned sub-study of the INDEED multicentre prospective cohort study, including independent or semi-independent seniors (≥65 years old) admitted to hospital after an ED stay ≥8 hours and who were not delirious...
October 16, 2017: CJEM
https://www.readbyqxmd.com/read/29023081/frailty-predicts-adverse-outcomes-in-older-people-with-diabetes
#3
Joanna Ulley, Ahmed H Abdelhafiz
The greatest proportional increase in the number of people with diabetes by age group is predicted to occur in those aged 60 to 79. In older people living with diabetes, geriatric syndromes, which indicate frailty, are emerging as a third category of complications in addition to the traditional microvascular and macrovascular sequelae. Frailty is defined by the presence of three or more phenotypes (weight loss, weakness, decreased physical activity, exhaustion and slow gait speed). The presence of one or two phenotypes describes a pre-frail state, and the absence of phenotypes describes a non-frail person...
January 2017: Practitioner
https://www.readbyqxmd.com/read/28993099/recognising-older-frail-patients-near-the-end-of-life-what-next
#4
Magnolia Cardona-Morrell, Ebony Lewis, Sanjay Suman, Cilla Haywood, Marcella Williams, Audrey-Anne Brousseau, Sally Greenaway, Ken Hillman, Elsa Dent
Frailty is a state of vulnerability resulting from cumulative decline in many physiological systems during a lifetime. It is progressive and considered largely irreversible, but its progression may be controlled and can be slowed down and its precursor -pre-frailty- can be treated with multidisciplinary intervention. The aim of this narrative review is to provide an overview of the different ways of measuring frailty in community settings, hospital, emergency, general practice and residential aged care; suggest occupational groups who can assess frailty in various services; discuss the feasibility of comprehensive geriatric assessments; and summarise current evidence of its management guidelines...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28990989/enhancing-care-of-aged-and-dying-prisoners-is-e-learning-a-feasible-approach
#5
Susan J Loeb, Janice Penrod, Valerie H Myers, Brenda L Baney, Sophia M Strickfaden, Erin Kitt-Lewis, Rachel K Wion
BACKGROUND: Prisons and jails are facing sharply increased demands in caring for aged and dying inmates. Our Toolkit for Enhancing End-of-life Care in Prisons effectively addressed end-of-life (EOL) care; however, geriatric content was limited, and the product was not formatted for broad dissemination. Prior research adapted best practices in EOL care and aging; but, delivery methods lacked emerging technology-focused learning and interactivity. PURPOSES: Our purposes were to uncover current training approaches and preferences and to ascertain the technological capacity of correctional settings to deliver computer-based and other e-learning training...
October 4, 2017: Journal of Forensic Nursing
https://www.readbyqxmd.com/read/28988184/influence-of-frailty-in-older-patients-undergoing-emergency-laparotomy-a-uk-based-observational-study
#6
Kat L Parmar, Lyndsay Pearce, Ian Farrell, Jonathan Hewitt, Susan Moug
INTRODUCTION: The National Emergency Laparotomy Audit (NELA) has reported that older patients (≥65 years) form a large percentage of emergency high-risk cases with increased postoperative morbidity and mortality. With the population continuing to age rapidly, it is clear that a greater understanding of the factors affecting surgical outcomes in older patients is required. Frailty is a relatively new concept taking into account a variety of factors that increase an individual's vulnerability to increased dependency and death...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28987309/risperidone-in-the-emergency-setting-is-associated-with-more-hypotension-in-elderly-patients
#7
Michael P Wilson, Kimberly Nordstrom, Austin Hopper, Austin Porter, Edward M Castillo, Gary M Vilke
BACKGROUND: Expert consensus panels have recommended risperidone as first-line treatment for agitation of psychiatric origin. However, there are few if any studies on this medication in the emergency setting. OBJECTIVES: To assess the hemodynamic effects of risperidone in an emergency department (ED) setting, stratified by age. METHODS: This is a structured chart review of all patients who received oral risperidone over a 6-year period in an ED setting, excluding patients who received this medication as a prescription refill...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28986161/screening-of-the-frail-patient-in-the-emergency-department-a-systematic-review
#8
Rasmus Jørgensen, Mikkel Brabrand
BACKGROUND: Several frailty rating scales have been developed to detect and screen for the level of frailty. It is uncertain what diagnostic value screening of frailty level have in the emergency department. AIM: To assess the accuracy of the screening tools used in the emergency department to detect frailty in patients≥65years by their ability to identify the risk of adverse outcomes. METHODS: An extensive medical literature search of Embase and PubMed was conducted, to identify studies using frailty screening scales in the emergency department...
October 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28985882/economic-evaluations-of-comprehensive-geriatric-assessment-in-surgical-patients-a-systematic-review
#9
Gilgamesh Eamer, Bianka Saravana-Bawan, Brenden van der Westhuizen, Thane Chambers, Arto Ohinmaa, Rachel G Khadaroo
BACKGROUND: Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. METHODS: A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28983385/can-geriatric-psychiatry-patients-complete-symptoms-self-reports-using-tablets-a-randomized-study
#10
Ghizlane Moussaoui, Ching Yu, Vincent Laliberté, Dominique Elie, Artin A Mahdanian, Benjamin Dawson, Marilyn Segal, Karl J Looper, Rej Soham
BACKGROUND: With our aging population and limited number of geriatric psychiatrists, innovations must be made in order to meet the growing demands for geriatric psychiatry services. Emerging technologies could greatly improve access to care and systematic data collection. METHODS: This randomized study compared completion rates and time to completion (primary outcomes) when using iPad technology vs. traditional paper forms to complete self-report psychiatric symptoms...
September 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28975679/an-emergency-department-observation-unit-is-a-feasible-setting-for-multidisciplinary-geriatric-assessments-in-compliance-with-the-geriatric-emergency-department-guidelines
#11
Lauren T Southerland, Anthony J Vargas, Lalitha Nagaraj, Tanya R Gure, Jeffery M Caterino
BACKGROUND: The Geriatric Emergency Department Guidelines recommend providing multidisciplinary geriatric assessment in the Emergency Department (ED), but these assessments can be difficult to coordinate and may prolong length of stay. Patients who need longer than a typical ED stay can be placed in an ED Observation Unit (Obs Unit). We investigated the effects of offering multidisciplinary assessments for ED patients in an Obs Unit. METHODS: Evaluation by a geriatric hospital consultation team, physical therapist, case manager, and/or pharmacist was made available to all Obs Unit patients...
October 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28971468/post-operative-delirium-in-elderly-people-diagnostic-and-management-issues-of-post-operative-delirium-in-elderly-people
#12
Christina Florou, Dimitrios Theofilopoulos, Styliani Tziaferi, Maria Chania
Hippocrates a Greek physician commonly known as the Father of Medicine was the first to describe delirium, 'phrenitis', differencing it from other disorders such as melancholia and mania. Since then, it still remains a clinical problem which is not yet resolved.Postoperative delirium is a common medical problem that occurs preferentially in surgical patients aged 65 years and older. It is a true medical emergency that requires immediate professional attention and treatment. Faced by health professionals and especially nurses it is often undetected, misdiagnosed, and under-treated as a complication by them during clinical care...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28966807/skin-cancer-epidemics-in-the-elderly-as-an-emerging-issue-in-geriatric-oncology
#13
REVIEW
Simone Garcovich, Giuseppe Colloca, Pietro Sollena, Bellieni Andrea, Lodovico Balducci, William C Cho, Roberto Bernabei, Ketty Peris
Skin cancer is a worldwide, emerging clinical need in the elderly white population, with a steady increase in incidence rates, morbidity and related medical costs. Skin cancer is a heterogeneous group of cancers comprising cutaneous melanoma and non-melanoma skin cancers (NMSC), which predominantly affect elderly patients, aged older than 65 years. Melanoma has distinct clinical presentations in the elderly patient and represents a challenging question in terms of clinical management. NMSC includes the basal cell carcinoma and cutaneous squamous cell carcinoma and presents a wide disease spectrum in the elderly population, ranging from low-risk to high-risk tumours, advanced and inoperable disease...
October 2017: Aging and Disease
https://www.readbyqxmd.com/read/28960240/elder-friendly-emergency-department-development-and-validation-of-a-quality-assessment-tool
#14
Jane McCusker, T T Minh Vu, Nathalie Veillette, Sylvie Cossette, Alain Vadeboncoeur, Antonio Ciampi, Deniz Cetin-Sahin, Eric Belzile
OBJECTIVES: To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care. DESIGN: Four-step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and clinical judgment, (4) reliability and validity assessment. SETTING: Province of Quebec, Canada. PARTICIPANTS: Lead ED nurses and physicians at 76 Quebec EDs who participated in a 2013/14 survey (66% of 116 adult nonpsychiatric EDs in the province)...
September 27, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28956283/the-effect-of-computerized-physician-order-entry-template-modifications-on-the-administration-of-high-risk-medications-in-older-adults-in-the-emergency-department
#15
Mitchell Kim, Stephen J Kaplan, Steven H Mitchell, Medley Gatewood, Itay Bentov, Katherine A Bennett, Carol A Crawford, Paul R Sutton, Diane Matsuwaka, Mamatha Damodarasamy, May J Reed
BACKGROUND: Older adults are more susceptible to adverse events when administered certain medications at doses appropriate for younger adults. OBJECTIVE: The aim of this study was to investigate the effect of default geriatric dosing on computerized physician order entry (CPOE) templates on the subsequent administration of recommended starting doses of opioids, benzodiazepines (BZDs) and non-steroidal anti-inflammatory drugs (NSAIDs) to older adults in the emergency department (ED)...
September 27, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28932652/psychosocial-treatment-options-for-major-depressive-disorder-in-older-adults
#16
Brenna N Renn, Patricia A Areán
Late-life depression (LLD) is a public health concern with deleterious effects on overall health, cognition, quality of life, and mortality. Although LLD is relatively common, it is not a normal part of aging and is often under-recognized in older adults. However, psychotherapy is an effective treatment for LLD that aligns with many patients' preferences and can improve health and functioning. This review synthesized the current literature on evidence-based psychotherapies for the treatment of depression in older adults...
March 2017: Current Treatment Options in Psychiatry
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#17
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28923012/prevalence-of-frailty-and-its-associated-factors-in-older-hospitalised-patients-in-vietnam
#18
Huyen Thi Thanh Vu, Thanh Xuan Nguyen, Tu N Nguyen, Anh Trung Nguyen, Robert Cumming, Sarah Hilmer, Thang Pham
BACKGROUND: Frailty is an emerging issue in geriatrics and gerontology. The prevalence of frailty is increasing as the population ages. Like many developing countries, Vietnam has a rapidly ageing population. However, there have been no studies about frailty in older people in Vietnam. This study aims to investigate the prevalence of frailty and its associated factors in older hospitalised patients at the National Geriatric Hospital in Hanoi, Vietnam. METHODS: Prospective observational study in inpatients aged ≥60 years at the National Geriatric Hospital in Hanoi, Vietnam from 4/2015 to 10/2015...
September 15, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28922992/policy-maker-attitudes-to-the-ageing-of-the-hiv-cohort-in-botswana
#19
Kabo Matlho, Refelwetswe Lebelonyane, Tim Driscoll, Joel Negin
BACKGROUND: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at international level, no clear defined intervention strategy has been established in many highly affected countries. Therefore we explored attitudes of policy-makers and service providers towards HIV among older adults (50 years or older) in Botswana...
December 2017: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
https://www.readbyqxmd.com/read/28922625/living-and-dying-with-advanced-dementia-a-prospective-cohort-study-of-symptoms-service-use-and-care-at-the-end-of-life
#20
Elizabeth L Sampson, Bridget Candy, Sarah Davis, Anna Buylova Gola, Jane Harrington, Michael King, Nuriye Kupeli, Gerry Leavey, Kirsten Moore, Irwin Nazareth, Rumana Z Omar, Victoria Vickerstaff, Louise Jones
BACKGROUND: Increasing number of people are dying with advanced dementia. Comfort and quality of life are key goals of care. AIMS: To describe (1) physical and psychological symptoms, (2) health and social care service utilisation and (3) care at end of life in people with advanced dementia. DESIGN: 9-month prospective cohort study. SETTING AND PARTICIPANTS: Greater London, England, people with advanced dementia (Functional Assessment Staging Scale 6e and above) from 14 nursing homes or their own homes...
August 1, 2017: Palliative Medicine
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