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https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#1
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28808814/the-impact-of-being-a-migrant-from-a-non-english-speaking-country-on-healthcare-outcomes-in-frail-older-inpatients-an-australian-study
#2
David Basic, Chris Shanley, Rinaldo Gonzales
The purpose of this prospective study of 2180 consecutive index admissions to an acute geriatric service was to compare in-hospital outcomes of frail older inpatients born in non-English-speaking counties, referred to as culturally and linguistically diverse (CALD) countries in Australia, with those born in English-speaking countries. Multivariate logistic regression was used to model in-hospital mortality and new nursing home placement. Multivariate Cox proportional hazards regression was used to model length of stay...
August 14, 2017: Journal of Cross-cultural Gerontology
https://www.readbyqxmd.com/read/28804877/validation-of-a-geriatric-trauma-prognosis-calculator-a-p-a-l-li-a-t-e-consortium-study
#3
Allyson C Cook, Bellal Joseph, M Jane Mohler, Kenji Inaba, Brandon R Bruns, Paul A Nakonezny, Jeff D Kerby, Karen J Brasel, Steven E Wolf, Joseph Cuschieri, M Elizabeth Paulk, Ramona L Rhodes, Scott C Brakenridge, A Peter Ekeh, Herb A Phelan
BACKGROUND/OBJECTIVES: The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. DESIGN: Retrospective cohort...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28799961/nurses-perceptions-of-psychosocial-care-and-barriers-to-its-provision-a-qualitative-study
#4
Cassandra Siyun Chen, Sally Wai-Chi Chan, Moon Fai Chan, Suk Foon Yap, Wenru Wang, Yanika Kowitlawakul
BACKGROUND: Psychosocial care is the culturally sensitive provision of psychological, social, and spiritual care through therapeutic communication. Current evidence suggests that effective psychosocial care improves patients' health outcomes and quality of life. PURPOSE: The aim of this study was to explore nurses' perceptions and experiences in providing psychosocial care to patients and to identify the related barriers and challenges. METHODS: An exploratory qualitative design using semistructured, individual, face-to-face interviews was adopted...
August 10, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28799157/-social-medicine-and-interfaces-in-sectoral-health-care-provision
#5
Hans Gerber, Christian Alex, Michael Penz, Michael Röder, Gert von Mittelstaedt
In addition to the consideration of individual medicine, social medicine focuses on the social references of health and sickness. In this context, it reflects the structures of the entire health care system, its functions and its functional deficits. It deals with the specific interaction between medicine and society and functions such as a link to the classical social sciences (1). Of particular interest in this context are the interfaces to sectoral health care provision. The working group "Nursing Care" of the Department "Practical Social Medicine and Rehabilitation" of the German Society for Social Medicine and Prevention examines the fundamental interfaces in our sectoral health care system from the perspective of social medicine in their current functions and perspectives, particularly in view of the future demographic challenges to be faced...
August 10, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28797379/delirium
#6
REVIEW
Belinda Setters, Laurence M Solberg
Delirium is a common, often underdiagnosed, geriatric syndrome characterized by an acute change in attention and consciousness. As a neuropsychiatric disorder with an underlying organic cause, delirium has been considered a diagnosis reserved for the hospital setting. However, delirium is known to occur as both an acute and subacute condition that carries significant morbidity and mortality. Combined with its association with dementia and aging, this makes delirium an important topic for primary care providers to become more familiar with as they are tasked with caring for an aging population...
September 2017: Primary Care
https://www.readbyqxmd.com/read/28795663/-evaluation-function-of-intermedin-on-prognosis-of-elderly-patients-with-sepsis
#7
Yi Zhang, Fengxue Zhu, Weihuan Du, Yongmei He, Li Guo, Zhihong Yan, Hong Ji
OBJECTIVE: To investigate the predicting value of intermedin (IMD) for the prognosis of elderly sepsis patients. METHODS: A retrospective analysis was conducted. Forty-one patients with sepsis, aged ≥65 years, and admitted to geriatrics intensive care unit of Aerospace Center Hospital from April 2015 to December 2016 were enrolled. Thirty healthy patients were studied as control during the same time. The expression of C-reactive protein (CRP), procalcitonin (PCT) and IMD were tested within 24 hours during hospitalization, and the acute physiology and chronic health evaluation II (APACHE II) score and prognosis was evaluated...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795216/the-impact-of-pre-existing-conditions-on-functional-outcome-and-mortality-in-geriatric-hip-fracture-patients
#8
Christopher Bliemel, Benjamin Buecking, Ludwig Oberkircher, Matthias Knobe, Steffen Ruchholtz, Daphne Eschbach
PURPOSE: Due to pre-existing illnesses, elderly hip fracture patients represent a vulnerable patient population. The present study was conducted to investigate the effects of various pre-existing conditions on the outcomes of hip fracture patients. METHODS: A total of 402 surgically treated geriatric hip fracture patients were included in this prospective, single-centre study. Upon admission, patient age, gender and fracture type were documented, among other information...
August 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28792787/validation-of-the-supportive-and-palliative-care-indicators-tool-in-a-geriatric-population
#9
Reine De Bock, Nele Van Den Noortgate, Ruth Piers
BACKGROUND: Timely identification of patients in need of palliative care is especially challenging in a geriatric population because of prognostic uncertainty. The Supportive and Palliative Care Indicators Tool (SPICT™) aims at facilitating this identification, yet has not been validated in a geriatric population. OBJECTIVE: This study validates the SPICT in a geriatric patient population admitted to the hospital. DESIGN: This is a retrospective cohort study...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28776897/relationship-between-cortisol-reactivity-to-psychosocial-stress-and-declarative-memory-decline-during-aging-impact-of-age-and-sex
#10
Aline Talita Dos Santos, Dayse Maria D Leyendecker, Ana Lucia Siqueira Costa, Juliana Nery de Souza-Talarico
AIM: To analyze the relationship between memory performance and the neuroendocrine and cardiovascular response to acute psychosocial stress in healthy older people, and the sex and age impact in this relationship. METHODS: We randomly selected 100 literate older adults, without cognitive or functional impairment. The neuroendocrine stress response was evaluated by measuring the concentration of salivary cortisol, whereas cardiovascular reactions were determined based on blood pressure and heart rate measures taken before, during and after participant exposure to an acute psychosocial stressor ( the Trier social stress test [TSST])...
August 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28775217/end-of-life-services-for-older-people-in-residential-care-homes-in-hong-kong
#11
REVIEW
J K Luk
Good end-of-life care is needed for older people living in residential care homes with advanced irreversible chronic medical illnesses and cancers. At present, the usual practice of residential care homes is to send older residents to acute hospitals when they are unwell, and some residents will die in hospital. Dying in hospital without choice for older people may not be in alignment with the principle of 'good death'. There are many barriers for older people to die in the place of their choice, particularly in a residential care home...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28769556/increased-neutrophil-lymphocyte-ratio-in-delirium-a-pilot-study
#12
Angelique Egberts, Francesco Us Mattace-Raso
AIM: Delirium is a common and severe complication among older hospitalized patients. The pathophysiology is poorly understood, but it has been suggested that inflammation and oxidative stress may play a role. The aim of this pilot study was to investigate levels of the neutrophil-lymphocyte ratio (NLR) - a marker of systemic inflammation and oxidative stress - in patients with and without delirium. METHODS: This pilot study was performed within a retrospective chart review study that included acutely ill patients, 65 years and older, who were admitted to the ward of geriatrics of the Erasmus University Medical Center...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28765993/effects-of-acute-peripheral-central-visual-field-loss-on-standing-balance
#13
Caitlin O'Connell, Arash Mahboobin, Scott Drexler, Mark S Redfern, Subashan Perera, Amy C Nau, Rakié Cham
Vision impairments such as age-related macular degeneration (AMD) and glaucoma are among the top risk factors for geriatric falls and falls-related injuries. AMD and glaucoma lead to loss of the central and peripheral visual fields, respectively. This study utilized a custom contact lens model to occlude the peripheral or central visual fields in healthy adults, offering a novel within-subject approach to improve our understanding of the etiology of balance impairments that may lead to an increased fall risk in patients with visual field loss...
August 1, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28765414/acute-geriatrics-at-the-front-door
#14
Simon Conroy, Stuart Parker
Older people with frailty and urgent care needs are major uses of health and social care services. Comprehensive geriatric assessment (CGA) is an evidence-based approach to improving their outcomes, as well as improving service outcomes. Geriatricians form a small proportion of the overall workforce and cannot address the population need alone, so all clinicians (doctors, nurses, therapists and so on) need to engage in delivering CGA as a process of care, underpinned by specific competencies - which can be developed...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28754091/-visually-impaired-elderly-patient-ingests-pill-desiccant-leading-to-acute-hypoxic-respiratory-failure-requiring-intubation
#15
Wendy Gerstein, Ziyang Liu
BACKGROUND: A significant percentage of elderly patients suffer from both polypharmacy and visual impairment. This combination can increase the risk of an adverse event related to medication. This case highlights an unusual, but potentially deadly, medication adverse event. CASE PRESENTATION: A 77-year-old male, visually impaired, ingested a pill desiccant, believing it was the ampicillin/sulbactam tablet he was prescribed for an infected diabetic foot ulcer. He presented to the emergency room with inability to swallow, and imaging revealed the pill desiccant lodged in his upper esophagus...
July 28, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28750909/thank-you-for-asking-exploring-patient-perceptions-of-barcode-medication-administration-identification-practices-in-inpatient-mental-health-settings
#16
Gillian Strudwick, Carrie Clark, Brittany McBride, Moshe Sakal, Kamini Kalia
BACKGROUND: Barcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#17
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28744675/potentially-inappropriate-medication-at-hospital-admission-in-patients-with-palliative-care-needs
#18
Daniel Sevilla-Sánchez, Núria Molist-Brunet, Jordi Amblàs-Novellas, Joan Espaulella-Panicot, Carles Codina-Jané
Background Potentially inappropriate medications (PIMs) are common in older patients with polypharmacy, and are related to negative clinical results. Little information is available on the characteristics and consequences of PIMs in patients with advanced chronic conditions and palliative care needs. Objective To evaluate, for this population: (i) the prevalence of PIMs; (ii) the possible risk factors associated with its onset; and (iii) the related clinical consequences. Setting Acute-hospital care Geriatric Unit (AGU) in County of Osona, Spain...
July 25, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28743336/-analysis-of-factors-affecting-the-prognosis-of-icu-patients-by-multiple-logistic-regression-model-a-retrospective-cohort-study-of-1-299-patients-in-12-consecutive-years
#19
Jianfeng Liang, Zhiyong Li, Yan Zhang, Wei Zhang, Haishan Dong, Yun Zhang, Chang Xu, Maolong Gao
OBJECTIVE: To explore the prognostic factors of intensive care unit (ICU) patients. METHODS: A retrospective cohort study was conducted. The clinical data of patients admitted to ICU of Beijing Geriatric Hospital from January 2005 to December 2016 were collected. According to the prognosis, the patients were divided into death group and survival group, and the mortality trend with time and age was observed. Survival and death were treated as dependent variables, while the gender, age, reason of ICU admission, acute physiology and chronic health evaluation II (APACHE II) score, whether undergoing invasive mechanical ventilation (MV), invasive MV reason, duration of invasive MV, whether successful weaning, whether ICU nosocomial infection, hospital acquired pneumonia (HAP), central line-associated bloodstream infection (CLABSI), acute kidney injury (AKI) occurred, whether undergoing continuous blood purification (CBP), whether septic shock occurred, whether undergoing invasive hemodynamic monitoring or blood transfusion and length of ICU stay were used as the independent variables...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28739158/assessment-and-management-of-radiotherapy-induced-toxicity-in-older-patients
#20
Anita O'Donovan, Michelle Leech, Charles Gillham
Radiotherapy is an attractive treatment option for older adults, especially where surgery and chemotherapy pose too great a risk. Radiotherapy toxicity may be divided into acute/early and late effects of treatment. The latter may have limited relevance to an older patient with competing causes of mortality due to significant comorbidity. Altered fractionation regimes have been employed in numerous sites, with no significant toxicity impact. These offer greater convenience in the elderly, especially those with limited social support or in active caregiving roles...
July 21, 2017: Journal of Geriatric Oncology
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