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https://www.readbyqxmd.com/read/27916022/a-wandering-tube
#1
Ina Dubin, Moshe Gelber, Ami Schattner
The predominant causes of acute mechanical small bowel obstruction in geriatric patients are adhesions and hernias, which is not much different than in other adult age groups. Unusual etiologies may be encountered, such as volvulus or gallstone ileus, but a displaced feeding gastrostomy tube is a distinctly rare cause of intestinal obstruction which needs to be considered by emergency physicians as it may be increasingly encountered.
December 5, 2016: CJEM
https://www.readbyqxmd.com/read/27913598/describing-visible-acute-injuries-development-of-a-comprehensive-taxonomy-for-research-and-practice
#2
Tony Rosen, Christopher Reisig, Veronica M LoFaso, Elizabeth M Bloemen, Sunday Clark, Thomas J McCarthy, Estomih P Mtui, Neal E Flomenbaum, Mark S Lachs
BACKGROUND: Little literature exists classifying and comprehensively describing intentional and unintentional acute injuries, which would be valuable for research and practice. In preparation for a study of injury patterns in elder abuse, our goal was to develop a comprehensive taxonomy of relevant types and characteristics of visible acute injuries and evaluate it in geriatric patients. METHODS: We conducted an exhaustive review of the medical and forensic literature focusing on injury types, descriptions, patterns and analyses...
December 2, 2016: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/27913561/hospitals-and-patients-working-in-unity-how-r-u-protocol-for-a-prospective-feasibility-study-of-telephone-peer-support-to-improve-older-patients-quality-of-life-after-emergency-department-discharge
#3
Judy A Lowthian, Alyse Lennox, Andrea Curtis, Jeremy Dale, Colette Browning, De Villiers Smit, Gillian Wilson, Debra O'Brien, Cate Rosewarne, Lee Boyd, Cath Garner, Peter Cameron
INTRODUCTION: Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#4
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911313/challenges-in-screening-and-recruitment-for-a-neuroimaging-study-in-cognitively-impaired-geriatric-inpatients
#5
Ivayla Apostolova, Catharina Lange, Anna Roberts, Hans Joachim Igel, Anja Mäurer, Stephanie Liese, Melanie Estrella, Vikas Prasad, Elisabeth Stechl, Gernot Lämmler, Elisabeth Steinhagen-Thiessen, Ralph Buchert
BACKGROUND: Neuroimaging-based biomarkers have the potential to improve etiological diagnosis of cognitive impairment in elderly inpatients. However, there is a relative lack of studies on neuroimaging-based biomarkers in hospitalized geriatric patients, as the vast majority of neuroimaging studies in dementia have focused on memory clinic outpatients. An important aspect of study planning is a priori estimation of the rate of screen failures. OBJECTIVE: To report on the rate and causes of screen failures in a prospective study on the utility of neuroimaging (PET, MRI) for the etiological diagnosis of newly manifested cognitive impairment in acutely hospitalized geriatric patients...
November 28, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27910255/dysphagia-is-associated-with-functional-decline-during-acute-care-hospitalization-of-older-patients
#6
Haruyo Matsuo, Yoshihiro Yoshimura, Naoki Ishizaki, Tsuyoshi Ueno
AIM: Physical function is considered to be associated with dysphagia: however, there is little data regarding the association between dysphagia and functional decline during hospitalization among older patients. The aim of the present study was to investigate the prevalence of dysphagia, and the association between dysphagia and functional status during hospitalization in older acute-care patients. METHODS: A total of 103 older patients without present or prior history of diseases that could directly impair swallowing and cause dysphagia (45 men and 58 women; mean age 80...
December 1, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27910004/dabigatran-overdose-a-case-report-of-acute-hepatitis-extracorporeal-treatment
#7
Mariagrazia Porru, Antonella Mameli, Maria E Cianchetti, Mario Musu, Paola Schirru, Maria F Ruberto, Doris Barcellona, Francesco Marongiu
Dabigatran is an oral, direct thrombin inhibitor approved by international regulatory agencies for stroke prevention in patients with paroxysmal or persistent non-rheumatic atrial fibrillation (AF). The benefits of dabigatran are widely described, but its use in the geriatric population is not without risk. Chronic kidney disease is a common comorbidity with AF, and thus frequent checks of renal function in elderly patients are recommended. We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration...
December 1, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27901275/peripheral-nerve-blocks-for-the-treatment-of-headache-in-older-adults-a-retrospective-study
#8
Jacob R Hascalovici, Matthew S Robbins
OBJECTIVE: The objective of this study is to provide demographical and clinical descriptions of patients age 65 years old and older who were treated with peripheral nerve blocks (PNBs) at our institution and evaluate the safety and efficacy of this treatment. BACKGROUND: Headache disorders are common, disabling chronic neurological diseases that often persist with advancing age. Geriatric headache management poses unique therapeutic challenges because of considerations of comorbidity, drug interactions, and adverse effects...
November 30, 2016: Headache
https://www.readbyqxmd.com/read/27896467/audit-of-geriatric-hip-fracture-care-a%C3%A2-slovenian-trauma-center-analysis
#9
Dejan Krušič, Drago Brilej, Colin Currie, Radko Komadina
BACKGROUND: The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS: The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27888286/the-effectiveness-of-a-multidisciplinary-hip-fracture-care-model-in-improving-the-clinical-outcome-and-the-average-cost-of-manpower
#10
T W Lau, C Fang, F Leung
: After the implementation of the multidisciplinary geriatric hip fracture clinical pathway in 2007, the hospital length of stay and the clinical outcomes improves. Moreover, the cost of manpower for each hip fracture decreases. It proves that this care model is cost-effective. INTRODUCTION: The objective of this study is to compare the clinical outcomes and the cost of manpower before and after the implementation of the multidisciplinary geriatric hip fracture clinical pathway (GHFCP)...
November 26, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27878560/clinical-and-etiological-profile-of-epilepsy-in-elderly-a-hospital-based-study-from-rural-india
#11
Archana Verma, Alok Kumar
To determine the clinical profile and etiology of epilepsy in elderly patients in rural population of India which is in a phase of demographic transition with steadily growing geriatric population. A cross-sectional, prospective, hospital-based clinicoepidemiological study was performed from October 2014 to November 2015. Patients having onset of epilepsy after 60 years were incorporated in the study. We excluded the acute symptomatic seizures. One hundred and ten patients were enrolled and were divided into three standard subgroups: subgroup A (aged 60-70), subgroup B (aged 71-80), and subgroup C (aged 81-90)...
November 22, 2016: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/27868320/predictors-of-rehospitalization-among-older-adults-results-of-the-crime-study
#12
Federica Sganga, Francesco Landi, Stefano Volpato, Antonio Cherubini, Carmelinda Ruggiero, Andrea Corsonello, Paolo Fabbietti, Fabrizia Lattanzio, Ester Manes Gravina, Roberto Bernabei, Graziano Onder
AIM: To assess the predictors of readmission among older adults hospitalized in acute care wards. METHODS: A prospective cohort study was carried out among 921 hospitalized older adults participating in the CRiteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) project. The primary outcome of the study was rehospitalization within 1 year after discharge from acute care hospitals. We assessed the participants with a questionnaire including 350 items about demographic, social and clinical characteristics...
November 21, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27862784/does-being-assisted-by-care-workers-affect-antipsychotics-prescription-among-older-people-discharged-from-hospital
#13
Mirko Di Rosa, Paolo Fabbietti, Andrea Corsonello, Sergio Fusco, Federica Sganga, Stefano Volpato, Carmelinda Ruggiero, Graziano Onder, Fabrizia Lattanzio
AIM: Several factors can affect antipsychotic prescriptions, among which, caregivers. However, whether being assisted by a care worker might increase the rate of antipsychotic prescriptions at discharge from acute care hospital has not been previously investigated. We aimed to investigate whether being assisted by a care worker is associated with increased use of antipsychotics among older patients discharged from acute care hospitals. METHODS: The present series consisted of 928 patients not taking antipsychotics at admission in seven acute care wards of geriatric medicine in Italy (mean age 80...
November 10, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27862246/a-retrospective-analysis-of-mortality-in-captive-pygmy-hippopotamus-choeropsis-liberiensis-from-1912-to-2014
#14
Gabriella L Flacke, Suzana Tkalčić, Beatrice Steck, Kristin Warren, Graeme B Martin
The pygmy hippopotamus (Choeropsis liberiensis) is an IUCN Red List Endangered species (CITES Appendix II) that has been housed in zoological collections since 1912. As wild populations continue to decline throughout the species' range, successful ex situ breeding and management, including an understanding of morbidity and mortality, are of utmost importance. This study is the first comprehensive review of mortality data from the captive population since 1982 and significantly expands on previous analyses. We solicited necropsy reports from 129/187 zoological institutions worldwide that currently or previously held pygmy hippos and received data for 404 animals (177 ♂, 220 ♀, 7 undermined sex), representing 43% of pygmy hippos that have died in captivity...
November 2016: Zoo Biology
https://www.readbyqxmd.com/read/27858956/muscle-mass-loss-is-a-potential-predictor-of-90-day-mortality-in-older-adults-with-aspiration-pneumonia
#15
Keisuke Maeda, Junji Akagi
OBJECTIVES: To investigate the association between loss of muscle mass and aspiration pneumonia (AP). DESIGN: Prospective observational cohort. SETTING: Acute geriatric hospital. PARTICIPANTS: Individuals admitted to the hospital for AP (N = 151; mean age 85.9; 49.7% male). MEASUREMENTS: Appendicular skeletal muscle index (ASMI; appendicular skeletal muscle mass divided by height squared) was used to evaluate muscle mass...
November 17, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27843851/predictors-of-outcome-in-patients-admitted-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-a-rural-tertiary-care-center
#16
Abraham M Ittyachen, Smitha Krishnamoorthy, Arun N Bhatt, Shanavas Abdulla, Jijo Oommen Roy, M Sugathan, Kevin Ambadan, Jelty Kuriakose
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with a high degree of mortality and morbidity around the world with the burden of the disease being more in the developing countries. In the Indian context data is limited. This study was carried out to determine the predictors of outcome in patients admitted with acute exacerbation of COPD in a rural Tertiary Care Center in the state of Kerala. MATERIALS AND METHODS: This was a prospective cohort study...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27830996/permanent-emergency-inequality-in-access-to-hospitalisation-among-urban-elderly-chinese
#17
Tim F Liao, Cuntong Wang
The phenomenon of elderly patients staying in hospital emergency department observation units for extended time in urban China poses a challenge to China's healthcare system and presents a social problem of inequality. In this paper, we analyse statistics collected from 16 major public hospitals in Beijing to assess the extent and intensity of the problem and examine interviews of medical professionals to understand the mechanisms linking the issue to the Chinese healthcare system. We study the issue with the literature on market transition theory and on China's recent healthcare reforms and view this age-based inequality as an outcome of the economic and social transformations in China...
November 10, 2016: Global Public Health
https://www.readbyqxmd.com/read/27829011/rehabilitation-profiles-of-older-adult-stroke-survivors-admitted-to-intermediate-care-units-a-multi-centre-study
#18
Laura M Pérez, Marco Inzitari, Terence J Quinn, Joan Montaner, Ricard Gavaldà, Esther Duarte, Laura Coll-Planas, Mercè Cerdà, Sebastià Santaeugenia, Conxita Closa, Miquel Gallofré
BACKGROUND: Stroke is a major cause of disability in older adults, but the evidence around post-acute treatment is limited and heterogeneous. We aimed to identify profiles of older adult stroke survivors admitted to intermediate care geriatric rehabilitation units. METHODS: We performed a cohort study, enrolling stroke survivors aged 65 years or older, admitted to 9 intermediate care units in Catalonia-Spain. To identify potential profiles, we included age, caregiver presence, comorbidity, pre-stroke and post-stroke disability, cognitive impairment and stroke severity in a cluster analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27797638/preparing-older-adults-with-serious-illness-to-formulate-their-goals-for-medical-care-in-the-emergency-department
#19
Kei Ouchi, Vinicius Knabben, Laura Rivera-Reyes, Niharika Ganta, Laura P Gelfman, Rebecca Sudore, Ula Hwang
BACKGROUND: Emergency department (ED) clinicians often lack training and resources to conduct advance care planning (ACP) conversations. The use of technology for health education is increasing, yet little is known if it can be used to engage older ED patients in ACP. OBJECTIVE: To determine the feasibility of using tablets to provide ACP education ( www.prepareforyourcare.org )(PREPARE) to older ED patients. DESIGN: A feasibility study conducted in late 2014 and early 2015...
October 31, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27790616/a-comprehensive-comparison-of-the-efficacy-and-tolerability-of-racecadotril-with-other-treatments-of-acute-diarrhea-in-adults
#20
REVIEW
Wolfgang Fischbach, Viola Andresen, Marion Eberlin, Tobias Mueck, Peter Layer
Racecadotril is a guideline-recommended treatment to alleviate symptoms of acute diarrhea. A systematic review of randomized studies was performed comparing efficacy and safety of treatment with racecadotril to that with placebo or active treatments in adults. In five double-blind studies, racecadotril and placebo had comparable tolerability, but racecadotril was more effective. This was consistent across multiple efficacy parameters including duration of diarrhea, number of diarrheic stools, abdominal pain, and meteorism; it was also consistent across countries in Africa, Asia, and Europe...
2016: Frontiers in Medicine
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