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https://www.readbyqxmd.com/read/28722184/appropriateness-of-antiplatelet-therapy-for-primary-and-secondary-cardio-and-cerebrovascular-prevention-in-acutely-hospitalized-older-people
#1
I Ardoino, R Rossio, D Di Blanca, A Nobili, L Pasina, P M Mannucci, F Peyvandi, C Franchi
BACKGROUND: Antiplatelet therapy is recommended for the secondary prevention of cardio- and cerebrovascular disease, but for primary prevention it is advised only in patients at very high risk. With this background, this study aims to assess the appropriateness of antiplatelet therapy in acutely hospitalized older people according to their risk profile. METHODS: Data were obtained from the REPOSI register held in Italian and Spanish internal medicine and geriatric wards in 2012 and 2014...
July 19, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28721029/the-impact-of-transient-and-persistent-acute-kidney-injury-on-short-term-outcomes-in-very-elderly-patients
#2
Qinglin Li, Meng Zhao, Xiaodan Wang
OBJECTIVES: Acute kidney injury (AKI) is a common complication in elderly patients and is associated with poor outcomes. However, the effect of transient and persistent geriatric AKI on short-term mortality is unclear. We aimed to study the incidence, clinical characteristics, and prognostic impact of transient and persistent AKI in such patients. METHODS: We retrospectively enrolled very elderly patients (≥75 years) from the geriatric department of the Chinese PLA General Hospital between 2007 and 2015...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28717918/-syncope-falls-and-vertigo
#3
REVIEW
C Weingart, H-J Schneider, C C Sieber
Dizziness/vertigo, falls and syncope are among the most common reasons for seeking medical care. As clinical entities they share common pathogenetic and clinical features and differences. The diagnostic work-up can often be initiated in a general practitioner's or internist's practice and, if necessary, completed in an interdisciplinary emergency unit. Simple diagnostic tools can be used in an outpatient setting to obtain valuable diagnostic information. First and foremost, it is important to differentiate between prognostically favorable clinical events and potentially serious disease...
July 17, 2017: Der Internist
https://www.readbyqxmd.com/read/28707364/furosemide-use-and-acute-risk-of-hip-fracture-in-older-people-a-nationwide-case-control-study-in-taiwan
#4
Shih-Wei Lai, Kao-Chi Cheng, Cheng-Li Lin, Kuan-Fu Liao
AIM: Little is known about the acute effects of furosemide use on the risk of hip fracture. The aim of the present study was to evaluate the association between furosemide use and acute risk of hip fracture in older people in Taiwan. METHODS: We carried out a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. A total of 4523 older adults aged ≥65 years with newly diagnosed hip fracture from 2000 to 2013 were identified as the cases...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#5
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697926/health-literacy-and-health-outcomes-in-very-old-patients-with-heart-failure
#6
Rocío León-González, Esther García-Esquinas, Emilio Paredes-Galán, Ana Isabel Ferrero-Martínez, José-Luis González-Guerrero, Mercedes Hornillos-Calvo, Rocío Menéndez-Colino, Ivett Torres-Torres, María Concepción Galán, Marta Torrente-Carballido, Mayte Olzcoz-Chiva, Carlos Rodríguez-Pascual, Fernando Rodríguez-Artalejo
INTRODUCTION AND OBJECTIVES: Health literacy (HL) has been associated with lower mortality in heart failure (HF). However, the results of previous studies may not be generalizable because the research was conducted in relatively young and highly-educated patients in United States settings. This study assessed the association of HL with disease knowledge, self-care, and all-cause mortality among very old patients, with a very low educational level. METHODS: This prospective study was performed in 556 patients (mean age, 85 years), with high comorbidity, admitted for HF to the geriatric acute-care unit of 6 hospitals in Spain...
July 8, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28687265/contextualizing-myocardial-infarction-comorbidities-and-priorities-in-older-adults
#7
REVIEW
Ashok Krishnaswami, Mathew S Maurer, Karen P Alexander
Cardiovascular care for older adults has become increasingly complex due to a rise in the concurrent comorbidity burden that accompanies senescence. Internists, hospitalists, and cardiologists often encounter geriatric patients with multiple chronic conditions needing acute cardiovascular care. Abnormal cardiac biomarker levels in patients with multiple non-cardiac conditions are a common reason for older adults to enter the hospital. This type of acute coronary syndrome, defined as a non-ST segment elevation myocardial infarction or, more precisely, type 2 myocardial infarction, often leads to substantial consternation...
July 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28683706/sarcopenia-what-should-a-pharmacist-know
#8
Alfonso J Cruz-Jentoft
Sarcopenia (or muscle insufficiency) is a geriatric syndrome characterized by a progressive and generalized loss of skeletal muscle mass and function which has adverse consequences, particularly physical disability, falls and death. It can develop slowly, as a chronic condition that emerges over many years, or acutely, generally due to immobilization associated with an acute disease. The physiopathology of sarcopenia is complex, and affects both the muscle and its neurological and hormonal regulation...
July 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28675566/effects-of-two-different-glutamine-containing-enteral-supplements-on-stool-frequency-and-density-in-elderly-patients-recovering-from-acute-critical-illness
#9
Nobutoshi Fushimi, Munenori Yamada, Hiroki Hachiya, Shun Ito, Takashi Shibuya, Noritsugu Ohashi, Akihiro Mori
AIM: Glutamine has various beneficial functions in the gastrointestinal tract. The present study was designed to investigate the effect of two different glutamine supplements on bowel movement at the start of enteral feeding in elderly inpatients. METHODS: This was a double-blind, prospective, randomized comparison study. A total of 25 patients aged >75 years recovering from a critical illness in a non-intensive care unit and scheduled for tube feeding were recruited...
July 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28658156/comprehensive-geriatric-care-reduces-acute-perioperative-delirium-in-elderly-patients-with-hip-fractures-a-meta-analysis
#10
REVIEW
Yiyang Wang, Jun Tang, Feiya Zhou, Lei Yang, Jianbin Wu
BACKGROUND: The aim of the current meta-analysis was to assess the treatment effect of comprehensive geriatric care in reducing acute perioperative delirium in older patients with hip fractures, compared with the effect of a routine orthopedic treatment protocol. METHODS: We conducted a search of multiple databases to identify randomized controlled trials (RCTs) and quasi-RCTs comparing comprehensive geriatric care and routine orthopedic treatment regarding the following outcomes: incidence of delirium, assessment of cognitive status, and duration of delirium...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655169/hospital-at-home-integrated-care-programme-for-the-management-of-disabling-health-crises-in-older-patients-comparison-with-bed-based-intermediate-care
#11
Miquel À Mas, Marco Inzitari, Sergi Sabaté, Sebastià J Santaeugènia, Ramón Miralles
Objective: to analyse the clinical impact of a home-based Intermediate Care model in the Catalan health system, comparing it with usual bed-based care. Design: quasi-experimental longitudinal study. Setting: hospital Municipal de Badalona and El Carme Intermediate Care Hospital, Badalona, Catalonia, Spain. Participants: we included older patients with medical and orthopaedic disabling health crises in need of Comprehensive Geriatric Assessment (CGA) and rehabilitation...
June 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28652180/serum-levels-of-dickkopf-1-are-a-potential-negative-biomarker-of-survival-in-geriatric-patients
#12
Peter Dovjak, Georg Heinze, Anna Rainer, Wolfgang Sipos, Peter Pietschmann
Fragility fractures due to osteoporosis and its most dreaded complication - hip fractures - are the cause of disability, high mortality and place a considerable burden on global health economics. Although much work has been done to accurately predict mortality and find risk factors for poor health outcome, little attention was given to the Wnt-catenin signaling pathway and its role in the posttraumatic course of disease. We studied 238 geriatric patients (175 women (mean age 84yrs) and 63 men (mean age 82yrs)) in total that were admitted to a department of Acute Geriatric Care...
June 23, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28647292/risk-factors-of-refeeding-syndrome-in-malnourished-older-hospitalized-patients
#13
Maryam Pourhassan, Ingeborg Cuvelier, Ilse Gehrke, Christian Marburger, Mirja Katrin Modreker, Dorothee Volkert, Hans-Peter Willschrei, Rainer Wirth
BACKGROUND & AIMS: Despite the high prevalence of malnutrition among older hospitalized persons, it is unknown how many of these malnourished patients are at risk of developing the refeeding syndrome (RFS). In this study, we sought to compare the prevalence and severity of malnutrition among older hospitalized patients with prevalence of known risk factors of RFS. METHODS: This cross-sectional multicenter-study investigated older participants who were consecutively admitted to the geriatric acute care ward...
June 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28642623/predicting-long-term-mortality-in-hospitalized-elderly-patients-using-the-new-espen-definition
#14
Jiaojiao Jiang, Xiaoyi Hu, Jing Chen, Haozhong Wang, Lei Zhang, Birong Dong, Ming Yang
The European Society of Clinical Nutrition and Metabolism (ESPEN) recently published new diagnostic criteria for malnutrition. The aim of this study was to evaluate whether malnutrition by the new ESPEN diagnostic criteria can predict long-term mortality in elderly inpatients. We conducted a prospective study in the acute geriatric wards. Malnutrition was defined according to the new ESPEN criteria and the Mini Nutritional Assessment (MNA), respectively. The survival status was determined by telephone interviews at 3-years...
June 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28631275/a-typology-of-interprofessional-teamwork-in-acute-geriatric-care-a-study-in-55-units-in-belgium
#15
Ruth D Piers, Karen J J Versluys, Johan Devoghel, Sophie Lambrecht, André Vyt, Nele J Van Den Noortgate
OBJECTIVES: To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. DESIGN: Cross-sectional multicenter study. SETTING: Acute geriatric units in Belgium. PARTICIPANTS: Team members of different professional backgrounds. MEASUREMENTS: Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents...
June 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28625940/prodromal-stage-of-disease-dementia-with-lewy-bodies-how-to-diagnose-in-practice
#16
Frédéric Blanc, Marc Verny
Disease with Lewy bodies or dementia with Lewy bodies (DLB), particularly at the prodromal stage, is a complex disease to diagnose because of different clinical beginnings and variable paths in terms of clinical expression. Thus DLB can be entcountered in different input modes: mild cognitive impairment, depression, acute behavioral disorders, confusion and delirium, or sleep disorders. In the aim to better diagnose the disease, should be sought obviously to search for the key symptoms: fluctuations, hallucinations, extra-pyramidal syndrome, and REM sleep behavior disorder...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#17
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/28625178/endoscopic-electrocautery-and-fibrin-obliteration-of-an-acutely-complicated-pyriform-fossa-sinus-tract-in-a-septuagenarian
#18
R Heyes, A G Aulakh, R K Lingam, T Tatla
BACKGROUND: Pyriform fossa sinus tracts classically present with neck abscess, recurrent infections and suppurative thyroiditis in children; acute presentation in a geriatric patient is rare. METHODS: Case report and Medline literature review. CASE REPORT: A 79-year-old female presented with a left-sided neck mass and severe odynophagia of 3 days' duration. Magnetic resonance imaging revealed a large-volume, loculated fluid collection extending throughout the deep spaces of the neck on the left, within and around the thyroid gland capsule...
June 19, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28612154/frailty-phenotype-and-the-role-of-levodopa-challenge-test-in-geriatric-inpatients-with-mild-parkinsonian-signs
#19
Piotr Seiffert, Jarosław Derejczyk, Jacek Kawa, Czesław Marcisz, Małgorzata Czernek, Jan Szymszal, Wojciech Kapko, Monika Bugdol, Anna Torbus, Olga Stępień-Wyrobiec
Deficiency in dopaminergic system function may be one of the hypothetical reasons of the frailty syndrome but its role still remains unclear. The aim of our study was to assess the frailty phenotype prevalence in geriatric inpatients with mild parkinsonian signs (MPS) and to investigate levodopa test in the frail patients with MPS. We examined 118 participants: 90 with MPS and 28 in control group (without MPS). The frailty syndrome presence was evaluated by the Fried criteria. Deficiency in dopaminergic system function was assessed by one of the modifications of an acute levodopa challenge test (LCT): in MPS group every patient was examined by performing Up and Go Test and also Step Test before and 3 h after taking 125 mg of Madopar (levodopa + benserazide)...
June 13, 2017: Biogerontology
https://www.readbyqxmd.com/read/28604410/feasibility-and-neurobehavioral-changes-of-10-day-simulated-microgravity-in-acute-ischemic-stroke-patients
#20
Kyo-In Koo, Dae Kwon Park, Chang Ho Hwang
OBJECTIVE: The aim of the study was to investigate feasibility and functional changes of simulated microgravity with 6-degree head-down-tilt (HDT) bed rest in acute ischemic stroke. DESIGN: Patients without lesions in the cingulate cortex and/or cerebellum were enrolled. They underwent HDT for 30 minutes twice per day for 10 weekdays. Systolic blood pressure, diastolic blood pressure, and heart rate were measured before the HDT, immediately after, and also 30 minutes after the stop...
June 9, 2017: American Journal of Physical Medicine & Rehabilitation
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