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Geriatric emergencies

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https://www.readbyqxmd.com/read/29784465/-proper-use-of-fluoroquinolones-in-hospitalized-elderly-patients-realisation-of-a-clinical-audit-in-geriatric-hospitals-of-lyon-university-hospital
#1
C Papailhau, S Gaujard, R Girard, L Bourguignon, C Mouchoux
INTRODUCTION: Fluoroquinolones (FQ) are widely used because of their broad spectrum and their ease of use, especially in the elderly. Nevertheless, their misuse is behind the development and the emergence of bacterial resistances. The objective of this study was to evaluate the compliance of FQ prescriptions in the elderly hospitalized, before and after pharmaceutical interventions (PI). METHODS: A prospective clinical audit was conducted for three months in three geriatric hospitals...
May 18, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29780223/surgical-outcomes-and-predictors-of-complication-in-elderly-patients-with-meningiomas
#2
Ayman E Galhom, A A Madawi, M M Ellabban
Background: Surgical management of symptomatic meningioma in elderly is still a high-risk surgery due to increased incidence of complication rate. Many scoring systems have been proposed to expect the surgical risk and the outcome.The study tries to assess cranial meningioma surgery in elderly using the Ibañez grade for complication rate and the Geriatric Scoring System (GSS) for the surgical outcome (GSS). Methods: A clinical and radiological data were studied retrospectively in 42 patients with a primary intracranial meningioma at or above the age of 65...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29779614/the-emerging-field-of-geriatric-otolaryngology
#3
REVIEW
David Eibling, Karen Kost
Sub-specialization within otolaryngology, like other specialties, is driven by accumulation of new knowledge and technology. For a variety of reasons, the establishment of a new subspecialty of geriatric otolaryngology is unlikely. Education of all otolaryngologists in the basic principles of gerontology and geriatric otolaryngology is achievable and represents a preferred strategy.
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29764534/geriatric-emergency-medicine-research-priorities-to-respond-to-the-silver-boom
#4
Don Melady
No abstract text is available yet for this article.
May 2018: CJEM
https://www.readbyqxmd.com/read/29742626/delta-alert-expanding-gerotrauma-criteria-to-improve-patient-outcomes-a-2-year-study
#5
Lynn L Wiles, Mark D Day
BACKGROUND/SIGNIFICANCE: Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. PURPOSE: The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. METHODS: Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29738900/multimorbidity-patterns-and-associations-with-functional-limitations-among-an-aging-population-in-prison
#6
Madison L Gates, Elizabeth G Hunter, Vivian Dicks, Peace N Jessa, Veronica Walker, Wonsuk Yoo
OBJECTIVES: Co-occurring chronic diseases are associated with functional limitations, particularly for the aging population ≥50 years old. Aging offenders (individual who are imprisoned) tend to have greater prevalence of chronic, mental health, and substance use disorders compared to non-imprisoned populations. Our primary aim was to determine patterns of co-occurring conditions associated with functional limitations among aging offenders. MATERIALS AND METHODS: We included all male offenders from one correctional system who were ≥50 years old (n = 2270) and extracted diagnoses for chronic diseases, mental health, substance use disorders, and functional limitations from an electronic health record...
April 2, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29738400/using-a-validated-middle-age-and-geriatric-risk-tool-to-identify-early-48hr-hospital-mortality-and-associated-cost-of-care
#7
Ariana Lott, Jack Haglin, Hesham Saleh, Jordan Hall, Kenneth A Egol, Sanjit R Konda
OBJECTIVES: 1) Demonstrate that a validated trauma triage score for middle-aged and geriatric patients could identify those at high risk for mortality within the first two days of hospitalization and 2) determine the cost of care for this cohort of patients DESIGN:: Prospective cohort study SETTING:: Single Level 1 Trauma Center PATIENTS:: Patients 55 years and older who were evaluated in the emergency department setting by Orthopaedics or who met American College of Surgeons Tier 1-3 criteria INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional statusMain Outcome Measurements: length of stay, inpatient mortality, time between presentation and time of death, and direct variable costs of hospitalization RESULTS:: A total of 1470 consecutive patients (mean age of 72...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29731391/outcomes-and-provider-perspectives-on-geriatric-care-by-a-nurse-practitioner-led-community-paramedicine-program
#8
Rebecca E Kant, Maria Vejar, Bennett Parnes, Joy Mulder, Andrea Daddato, Daniel D Matlock, Hillary D Lum
This study explores the use of a nurse practitioner-led paramedicine program for acute, home-based care of geriatric patients. This case series describes patients, outcomes, and geriatric primary care provider perspectives related to use of this independent paramedicine program. There were 40 patient visits from August 2016-May 2017. We reviewed patient demographics, medical conditions, healthcare utilization, and communication processes and used semi-structured interviews and content analysis to explore staff perspectives...
May 3, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29728985/prognostic-value-of-cardiac-troponin-i-assay-in-hospitalized-elderly-patients
#9
Francesca Attanasio, Pamela Carrer, Anna Zurlo, Anna Rossi, Luciano Babuin, Monica Maria Mion, Martina Zaninotto, Mario Plebani, Sabino Iliceto, Enzo Manzato, Valter Giantin
BACKGROUND: Cardiac troponin I (cTnI) has been poorly studied in elderly inpatients. AIM: This study wanted to assess factors influencing the increase in cTnI and its prognostic value in hospitalized elderly patients. METHODS: 354 elderly (mean age of 84.8 ± 6.9 years) patients consecutively admitted in the Geriatrics Division in Padua were tested for cTnI levels assay during the hospital stay. Number of subsequent patient deaths at 6 months and 2 years were registered...
May 4, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29717755/mediterranean-diet-food-consumption-and-risk-of-late-life-depression-the-mugello-study
#10
G Pagliai, F Sofi, F Vannetti, S Caiani, G Pasquini, R Molino Lova, F Cecchi, S Sorbi, C Macchi
OBJECTIVES: To investigate eating habits and adherence to Mediterranean Diet (MD) in relation to the risk of depression in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues, including those related to nutritional status. DESIGN: Cross-sectional study. SETTING: Homes and nursing homes in the Mugello area, Florence, Italy...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29714995/issues-in-geriatric-care-medical-decision-making
#11
Jayesh Patel, Richard J Ackermann
Medical decision-making capacity (DMC), which is determined by clinicians, is the ability of patients to understand information about options for their care, express a choice among those options, appreciate the benefits and risks of those options, and explain the reasoning behind their particular choice. DMC differs from competence, which is a legal concept concerning the mental ability of individuals to be responsible for their decisions and actions. A variety of instruments can be used to assess DMC. If it is determined that a patient lacks DMC, clinicians have an ethical obligation to seek out a surrogate decision-maker...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29714993/issues-in-geriatric-care-falls
#12
Dipesh Patel, Richard J Ackermann
One in three older adults falls each year. There are approximately 2.5 million falls among older adults treated in emergency departments. Falls account for 87% of all fractures in this age group. The biggest risk factor for falling is a history of falls. Other risk factors include frailty, sedative and anticholinergic drugs, polypharmacy, and a variety of medical conditions. Current recommendations are that all patients age 65 years and older should be asked about falls each year. Patients also can be screened for fall risk with a variety of approaches including questionnaires and the Timed Up & Go test...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29701179/guidelines-for-certification-of-international-normalized-ratio-inr-for-vitamin-k-antagonists-monitoring-according-to-the-en-iso-22870-standards
#13
Marie Brionne-François, Anne Bauters, Christine Mouton, Sophie Voisin, Claire Flaujac, Agnès Le Querrec, Dominique Lasne
Point of care testing (POCT) must comply with regulatory requirements according to standard EN ISO 22870, which identify biologists as responsible for POCT. INR for vitamin K antagonists (VKAs) monitoring is a test frequently performed in haemostasis laboratories. Bedside INR is useful in emergency room, in particular in case of VKAs overdosage but also for specific populations of patients like paediatrics or geriatrics. INR POCT devices are widely used at home by the patients for self-testing, but their use in the hospital by the clinical staff for bedside measurement is growing, with devices which now comply with standard for POCT accreditation for hospital use...
April 27, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29697042/dispatcher-cpr-instructions-across-the-age-continuum
#14
Kristi L Weinmeister, E Brooke Lerner, Clare E Guse, Khalid A Ateyyah, Ronald G Pirrallo
BACKGROUND: Survival rates following out-of-hospital cardiac arrest (OHCA) increase two to three times when cardiopulmonary resuscitation (CPR) is started by bystanders, as compared to starting CPR when Emergency Medical Services (EMS) arrives. Municipalities that have implemented dispatcher-assisted bystander CPR programs have seen increased rates of bystander CPR. Cardiopulmonary resuscitation instructions are given for victims of all ages, but it is unknown if offering instructions results in similar rates of EMS-documented bystander CPR across the age continuum in these municipalities...
April 26, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29691069/a-multidisciplinary-bootcamp-as-an-educational-launch-to-a-geriatric-emergency-department
#15
Allyson A Kreshak, Sean X Neath, Vaishal M Tolia, Edward M Castillo, Thoedore C Chan
BACKGROUND: Emergency department (ED) visits are increasing among patients ≥65 years of age. Geriatric EDs (GED) provide specialized emergency care for this older population. Interdisciplinary education of GED staff and providers is needed as part of the development of a GED. OBJECTIVES: We sought to describe the effective use of a GED bootcamp as an educational mechanism for the introduction of a GED to a health system. METHODS: An all-day, in-person GED bootcamp was held on the campus of our health system's medical school campus and was led by experts in geriatric emergency care...
April 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29683237/establishing-a-proactive-geriatrician-led-comprehensive-geriatric-assessment-in-older-emergency-surgery-patients-outcomes-of-a-pilot-study
#16
Matthew C Mason, Amy L Crees, Matthew R Dean, Nahida Bashir
INTRODUCTION: Increasing numbers of older adults are presenting with acute surgical disease to the unselected general surgical take. General surgeons have little training to manage these patients. We developed a pilot service of proactive geriatrician input into older emergency general surgical patients in a single institution. We wanted to demonstrate if geriatricians improve the management of these patients. METHODS: Patients aged 70 years or older admitted acutely under the general surgeons were assessed proactively by a geriatrician using comprehensive geriatric assessment (CGA)...
April 23, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29676874/-screening-of-frailty-in-the-emergency-unit-myth-or-reality
#17
A A Zulfiqar
At present, it is recognized that screening for frailty in the elderly is a major public health issue. Frailty screening in emergency unit is essential to optimize the management of elderly patients in hospital. Ideally, the role of a mobile geriatric team seems essential, taking over the frailty screening carried out in the emergency department, in order to optimize intra-hospital management and consequently reduce further intra-hospital visits and possible risks of decompensation of geriatric syndromes.
April 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29676780/retrospective-evaluation-of-a-restrictive-transfusion-strategy-in-older-adults-with-hip-fracture
#18
Lorene Zerah, Lucile Dourthe, Judith Cohen-Bittan, Marc Verny, Mathieu Raux, Anthony Mézière, Frédéric Khiami, Cendrine Tourette, Christian Neri, Yannick Le Manach, Bruno Riou, Hélène Vallet, Jacques Boddaert
OBJECTIVES: To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacute rehabilitation settings. DESIGN: Retrospective study. SETTING: Perioperative geriatric care unit. PARTICIPANTS: All individuals aged 70 and older admitted to the emergency department for hip fracture and hospitalized in our perioperative geriatric care unit (N=667; n=193 in the liberal transfusion group, n=474 in the restrictive transfusion group) from July 2009 to April 2016...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#19
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29662881/the-continuum-of-aging-and-age-related-diseases-common-mechanisms-but-different-rates
#20
REVIEW
Claudio Franceschi, Paolo Garagnani, Cristina Morsiani, Maria Conte, Aurelia Santoro, Andrea Grignolio, Daniela Monti, Miriam Capri, Stefano Salvioli
Geroscience, the new interdisciplinary field that aims to understand the relationship between aging and chronic age-related diseases (ARDs) and geriatric syndromes (GSs), is based on epidemiological evidence and experimental data that aging is the major risk factor for such pathologies and assumes that aging and ARDs/GSs share a common set of basic biological mechanisms. A consequence is that the primary target of medicine is to combat aging instead of any single ARD/GSs one by one, as favored by the fragmentation into hundreds of specialties and sub-specialties...
2018: Frontiers in Medicine
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