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https://www.readbyqxmd.com/read/29471574/-type-2-diabetes-diabetes-in-older-adults-example-for-patient-centered-drug-therapy
#1
Dirk Müller-Wieland
Diabetes in older adults has a high prevalence and is frequently associated with comorbidities of the cardiovascular system, dysfunction of cognition as well as depression and impaired mobility or increased frailty. Furthermore, impaired renal function, heart failure, risk for hypoglycemia and polypharmacy has to be considered in the decision about the diabetes treatment strategy. The goal of blood glucose management is driven by patient relevant issues and patient self-esteem, quality of life defined by the patient, preservation of physical and social mobility rather than potential long-term effects on reduction of cardio- and microvascular events in the future, which is limited by patient-inherent reduced life expectancy of the aged individual...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29468615/acute-care-hospital-at-different-levels-of-intensity-the-role-of-geriatrician
#2
REVIEW
Ilaria Liguori, Gennaro Russo, Luisa Aran, Giulia Bulli, Francesco Curcio, David Della-Morte, Gaetano Gargiulo, Gianluca Testa, Andrea Ungar, Francesco Cacciatore, Domenico Bonaduce, Pasquale Abete
The traditional model of care is based on "disease-centered" management that requires the organization of the hospital in specialized wards, to which the patient is assigned for the main disease. The growing need to optimize economical and human resources and to promote a global approach to the patient has led to the setting up of the intensity of care model. It is a health system based on a "patient-centered" approach, where the hospital is organized in departments dedicated to patients with homogenous needs of care...
February 21, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29464140/a-case-report-of-recombinant-tissue-plasminogen-activator-use-in-a-span-100-positive-geriatric-patient-with-thrombocytopenia
#3
Ilya Bragin, Justine M Chen
Thrombocytopenia (platelet count: < 100,000/mm3 ) is considered a contraindication in the use of intravenous thrombolysis for acute ischemic stroke. Little literature exists regarding tissue plasminogen activator (tPA) usage in thrombocytopenic patients, especially in older patients. Age and stroke severity are major prognostic indicators of the risk of hemorrhagic transformation. The Stroke Prognostication using Age and NIH Stroke Scale (SPAN) index estimates a patient's risk of intracerebral hemorrhage (ICH) and clinical response to thrombolysis by combining age in years with the National Institutes of Health Stroke Scale (NIHSS) scores...
December 11, 2017: Curēus
https://www.readbyqxmd.com/read/29457334/establishing-a-successful-perioperative-geriatric-service-in-an-australian-acute-surgical-unit
#4
Lauren Styan, Skyle Murphy, Aisling Fleury, Brian McGowan, Martin Wullschleger
BACKGROUND: The purpose of this study was to assess the impact of a perioperative geriatric service (PGS) in an acute surgical unit (ASU) on patient and organizational outcomes. METHODS: Single centre retrospective cohort study. Inclusion criteria were patients over the age of 65 admitted to the ASU between January and June 2014 (pre-PGS) and 2015 (post-PGS). Chart reviews were performed to identify outcomes of interest including in-hospital morbidity and mortality, length of stay (LOS), 30-day representation and mortality...
February 18, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29456030/acute-phase-nutritional-screening-tool-associated-with-functional-outcomes-of-hip-fracture-patients-a-longitudinal-study-to-compare-mna-sf-must-nrs-2002-and-gnri
#5
Tatsuro Inoue, Shogo Misu, Toshiaki Tanaka, Tetsuya Kakehi, Rei Ono
BACKGROUND & AIMS: Several hip fracture patients are malnourished, but no study has attempted to determine the optimal nutritional screening tool for predicting functional outcomes. We investigated the association between each nutritional status assessed by four nutritional screening tools at admission and functional outcomes during the postoperative acute phase in hip fracture patients. METHODS: The Mini Nutritional Assessment-Short Form (MNA-SF), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Score 2002 (NRS-2002) and the Geriatric Nutritional Risk Index (GNRI) were assessed at admission before surgery...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29445266/are-frail-elderly-patients-treated-in-a-cga-unit-more-satisfied-with-their-hospital-care-than-those-treated-in-conventional-acute-medical-care
#6
Niklas Ekerstad, Göran Östberg, Maria Johansson, Björn W Karlson
Objectives: Our aim was to study whether the acute care of frail elderly patients directly admitted to a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit in terms of patient satisfaction. Design: TREEE (Is the TReatment of frail Elderly patients Effective in an Elderly care unit?) is a clinical, prospective, controlled, one-center intervention trial comparing acute treatment in CGA units and in conventional wards...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29444179/capability-beliefs-on-and-use-of-evidence-based-practice-among-four-health-professional-and-student-groups-in-geriatric-care-a-cross-sectional-study
#7
Anne-Marie Boström, Disa K Sommerfeld, Annika W Stenhols, Anna Kiessling
Implementation of evidence-based practice (EBP) is a complex task. This study, conducted in an acute geriatric setting, aims to compare self-reported capability beliefs on EBP between health professionals and students, and to compare the use of EBP between health professional groups. Occupational therapists, physicians, physiotherapists and registered nurses with three or more months' employment, and all students from the occupational therapy, medical, physiotherapy and nursing programs, who had conducted workplace learning at the department, were invited...
2018: PloS One
https://www.readbyqxmd.com/read/29440681/a-sarcopenia-screening-test-predicts-mortality-in-hospitalized-older-adults
#8
Tianjiao Tang, Linna Wu, Ling Yang, Jiaojiao Jiang, Qiukui Hao, Birong Dong, Ming Yang
The aim of this study is to investigate the validation of a sarcopenia screening test (Ishii's formula) for predicting long-term mortality among older adult inpatients. A prospective, observational study was conducted in acute geriatric wards at three hospitals in western China. Sarcopenia was estimated using Ishii's formula. Survival status was assessed at 12, 24, and 36 months after the baseline investigation. Cox proportional-hazard models were applied to calculate the hazard ratio for mortality associated with sarcopenia...
February 13, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29439853/frailty-predicts-incident-urinary-incontinence-among-hospitalized-older-adults-a-1-year-prospective-cohort-study
#9
Edward Chong, Mark Chan, Wee Shiong Lim, Yew Yoong Ding
OBJECTIVES: The relationship between frailty and urinary incontinence (UI) remains highly complex. There is limited data on the impact of frailty on new-onset UI among hospitalized older adults. Thus, we examined the ability of frailty to predict incident UI among them. DESIGN: Prospective cohort study. SETTING: Acute geriatric unit at a large teaching hospital. PARTICIPANTS: Older adults hospitalized for an acute medical illness...
February 10, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29429905/health-related-quality-of-life-in-patients-with-poststroke-epilepsy
#10
Yaroslav Winter, Naeimeh Daneshkhah, Nikolaus Galland, Isabel Kotulla, Anna Krüger, Sergiu Groppa
BACKGROUND: Lesional epilepsy is an important long-term sequela of stroke. Data on health-related quality of life (HrQoL) in patients with poststroke epilepsy are limited. We investigated HrQoL in patients with epilepsy after ischemic stroke and identified independent HrQoL-determinants. METHODS AND PATIENTS: All patients with acute ischemic stroke, who were permanent residents in the district Marburg-Biedenkopf (Hessia, Germany, reference population 240,000 inhabitants) were recruited within 12months in the population-based Marburg Stroke Register (MARSTREG)...
February 8, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29423769/repeat-computed-tomography-scans-among-inter-facility-transferred-major-trauma-patients-in-oklahoma-2009-2015
#11
Yang Wan, Kenneth E Stewart, Martin Q Lansdale
PURPOSE: Computed tomography (CT) scans play a vital role in the diagnosis and evaluation of trauma patients. Repeat CT scans occurred often among transferred trauma patients. The objective was to describe CT use and identify patient- and hospital-level factors associated with repeat CT scans among inter-facility transferred major trauma patients. METHODS: A retrospective cohort study was conducted using data extracted from the Oklahoma State Trauma Registry between 2009 and 2015...
February 8, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29423259/comprehensive-geriatric-assessment-pilot-of-a-randomized-control-study-in-a-swedish-acute-hospital-a-feasibility-study
#12
Theresa Westgård, Isabelle Ottenvall Hammar, Eva Holmgren, Anna Ehrenberg, Aase Wisten, Anne W Ekdahl, Synneve Dahlin-Ivanoff, Katarina Wilhelmson
Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29416323/nutritional-variables-predict-chances-of-returning-home-and-activities-of-daily-living-in-post-acute-geriatric-care
#13
Keisuke Maeda, Takayuki Koga, Junji Akagi
Background: Little is known about the association between malnutrition and the chances of returning home from post-acute facilities in older adult patients. This study aimed to understand whether malnutrition and malnutrition-related factors would be determinants for returning home and activities of daily living (ADL) at discharge after post-acute care. Methods: Patients aged ≥65 years living at home before the onset of an acute disease and admitted to a post-acute ward were enrolled (n=207) in this prospective observational study...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29415841/interrater-reliability-of-the-volume-viscosity-swallow-test-screening-for-dysphagia-among-hospitalized-elderly-medical-patients
#14
Lise Walther Jørgensen, Kasper Søndergaard, Dorte Melgaard, Susan Warming
BACKGROUND: Oropharyngeal dysphagia (OD) is prevalent among medical and geriatric patients admitted due to acute illness and it is associated with malnutrition, increased length of stay and increased mortality. A valid and reliable bedside screening test for patients at risk of OD is essential in order to detect patients in need of further assessment. The Volume-Viscosity Swallow Test (V-VST) has been shown to be a valid screening test for OD in mixed outpatient populations. However, as reliability of the test has yet to be investigated in a population of medical and geriatric patients admitted due to acute illness, we aimed to determine the interrater reliability of the V-VST in this clinical setting...
December 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29412441/impact-of-sarcopenia-on-one-year-mortality-among-older-hospitalized-patients-with-impaired-mobility
#15
M Pourhassan, K Norman, M J Müller, R Dziewas, R Wirth
OBJECTIVES: However, the information regarding the impact of sarcopenia on mortality in older individuals is rising, there is a lack of knowledge concerning this issue among geriatric hospitalized patients. Therefore, aim of the present study was to investigate the associations between sarcopenia and 1-year mortality in a prospectively recruited sample of geriatric inpatients with different mobility and dependency status. DESIGN AND SETTING: Sarcopenia was diagnosed using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP)...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29405014/-sharing-perspectives-on-home-healthcare
#16
Pi-Shan Hsu, Jui-An Chen, Yu-Tso Chen, Han-Ming Wu, Szu-Ying Lee, Chung-Liang Lai
The baby boom after World War II, coupled with the rapid advances in medical technology and public health, has led to the current rapid aging in the world's population. Countries in Asia are experiencing a faster rate of aging than most other countries around the world. Taiwan is expected to advance from an aged society to a super-aged society in the next 7~10 years. Consequently, the demand for long-term care is increasing. The focus of healthcare has changed from acute to chronic, from disease-oriented to function-oriented and from cure to care...
February 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29397824/-clinical-efficacy-of-decitabine-combined-with-or-without-cytarabine-based-low-dose-regimen-for-senile-patients-with-acute-myeloid-leukemia
#17
Hong-Wei Zhou, Min-Hang Zhou, Zhi-Hong Wang, Peng-Fei Li, Mo Liu, Yu DU, Yi-Bing Yao, Chao-Jin Peng, Yu Jing, Jun-Zhong Sun
OBJECTIVE: To investigate the therapeutic effectiveness and side effects of decitabine combined with or without cytarabine-based low dose regimen for acute myeloid leukemia in geratic patients. METHODS: Clinical data of 8 geratic patients (aged over 70 years) suffered from acute myeloid leukemia from September 2009 to March 2012 were analyzed retrospectively, including age, sex, peripheral blood and bone marrow characteristics and so on. These patients were treated by an 1-hour intravenous infusion of decitabine 20 mg/m2 per day for 5 consecutive days every 4 weeks combined with or without low dose regimen dominantly consisting of cytarabine 20 mg per day as subcutaneous injection for seven consecutive days...
February 2018: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29397583/post-stroke-hypertension-control-and-receipt-of-health-care-services-among-veterans
#18
Dhanashri D Kohok, Jason J Sico, Fitsum Baye, Laura Myers, Jessica Coffing, Masoor Kamalesh, Dawn M Bravata
Many ischemic stroke patients do not achieve goal blood pressure (BP < 140/90 mm Hg). To identify barriers to post-stroke hypertension management, we examined healthcare utilization and BP control in the year after index ischemic stroke admission. This retrospective cohort study included patients admitted for acute ischemic stroke to a VA hospital in fiscal year 2011 and who were discharged with a BP ≥ 140/90 mm Hg. One-year post-discharge, BP trajectories, utilization of primary care, specialty and ancillary services were studied...
February 4, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29396192/management-of-nursing-home-residents-following-acute-hospitalization-efficacy-of-the-regular-early-assessment-post-discharge-reap-intervention
#19
Nicholas J Cordato, Mary Kearns, Peter Smerdely, Katrin M Seeher, Matthew D Gardiner, Henry Brodaty
OBJECTIVES: Rehospitalization of nursing home (NH) residents is frequent, costly, potentially avoidable and associated with diminished quality of life and poor survival. This study aims to evaluate the impact and cost-effectiveness of the Regular Early Assessment Post-Discharge (REAP) protocol of coordinated specialist geriatrician and nurse practitioner visits on rates of rehospitalization, hospital length of stay, and emergency department presentations for NH residents recently discharged from hospital...
January 30, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29393135/acute-kidney-injury-in-the-geriatric-population
#20
Mitchell H Rosner, Gaetano La Manna, Claudio Ronco
The aging kidney is more susceptible to injury. Thus, it is not surprising that acute kidney injury (AKI) is a disorder with a relative high incidence in the elderly population, especially those with critical illness. Given the comorbid conditions common in the geriatric population as well as the increase in exposure to various nephrotoxic insults, it is likely that the incidence of AKI will grow in the coming decades. Thus, it is critical to gain an understanding of the cellular and molecular pathways operative in increasing the susceptibility to AKI with an aim to design therapies that will mitigate the risk of AKI...
2018: Contributions to Nephrology
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