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Geriatric emergencies

Brittany Ellis, Christopher R Carpenter, Judy A Lowthian, Simon P Mooijaart, Christian H Nickel, Don Melady
No abstract text is available yet for this article.
March 16, 2018: CJEM
Giuseppe Pasqualetti, Valeria Calsolaro, Sara Bernardini, Giuseppe Linsalata, Renato Bigazzi, Nadia Caraccio, Fabio Monzani
Introduction: Although the association between low FT3 and poor outcome has been extensively reported in literature, the degree of peripheral thyroxin deiodination and its relationship with frailty and survival in hospitalized older patients has not been fully established yet. The aim of the current study was to evaluate the possible correlation between FT3/FT4 ratio reduction, an indirect marker of thyroxin deiodination impairment, and frailty status and survival in hospitalized older patients...
March 12, 2018: Journal of Clinical Endocrinology and Metabolism
Markus Kneihsl, Christian Enzinger, Kurt Niederkorn, Gerit Wünsch, Lisa Müller, Valeriu Culea, Andreas Lueger, Franz Fazekas, Thomas Gattringer
BACKGROUND: Stroke has become a treatable condition with increasing evidence of treatment benefits in older people. However, stroke mimics in geriatric patients are especially prevalent, causing incorrect suspicion and consecutive burden to patients and emergency room resources. We therefore examined the dimension of this problem by investigating emergency room admissions from nursing homes for suspected stroke. METHODS: We performed a retrospective cohort study of all nursing home residents who were admitted to the neurological emergency room of our primary and tertiary care university hospital between 2013 and 2015...
March 14, 2018: Cerebrovascular Diseases
Ann E Vandenberg, Katharina V Echt, Lawanda Kemp, Gerald McGwin, Molly M Perkins, Anna K Mirk
Suboptimal prescribing persists as a driver of poor quality care of older veterans and is associated with risk of hospitalization and emergency department visits. We adapted a successful medication management model, Integrated Management and Polypharmacy Review of Vulnerable Elders (IMPROVE), from an urban geriatric specialty clinic to rural community-based clinics that deliver primary care. The goals were to promote prescribing quality and safety for older adults, including reduced prescribing of potentially inappropriate medications (PIMs)...
March 2018: Journal of the American Geriatrics Society
Debi Prasad Mohapatra, Santosh Kumar Singh, Minu Sahoo, Shashank Patole, Mitali Mishra, Nagen Kumar Debata, Harapriya Mohapatra
PURPOSE: Antibiotic resistance patterns often exhibit geographical variations. Periodic analyses of resistance spectra and phylogenetic trends are important guides for facilitating judicious use of therapeutic interventions. The present study retrospectively analysed the infection trends, resistance patterns, and clonal relationships between isolates of Klebsiella spp. from a tertiary care hospital. METHODOLOGY: Bacterial isolates were collected from January 2013 to June 2014 and their resistance profiles were identified using an automated bacterial identification system...
March 9, 2018: Journal of Medical Microbiology
Ramin Fallahzadeh, Hassan Ghasemzadeh, Armin Shahrokni
PURPOSE OF REVIEW: The purpose of this review is to explore state-of-the-art remote monitoring and emerging new sensing technologies for in-home physical assessment and their application/potential in cancer care. In addition, we discuss the main functional and non-functional requirements and research challenges of employing such technologies in real-world settings. RECENT FINDINGS: With rapid growth in aging population, effective and efficient patient care has become an important topic...
March 8, 2018: Current Oncology Reports
Kah Poh Loh, Colin McHugh, Supriya G Mohile, Karen Mustian, Marie Flannery, Heidi Klepin, Rebecca Schnall, Eva Culakova, Erika Ramsdale
PURPOSE OF REVIEW: Older adults with cancer have complex medical needs and often experience higher rates of treatment-related toxicities compared to their younger counterparts. The advent of health information technologies can address multiple gaps in the care of this population. We review the role of existing and emerging technologies in facilitating the use of comprehensive geriatric assessment (CGA) in routine clinics, promoting symptom reporting, and monitoring medication adherence...
March 6, 2018: Current Oncology Reports
Angela Atinga, Andreas Shekkeris, Michael Fertleman, Nicola Batrick, Elika Kashef, Elizabeth Dick
Major Trauma Centres and Emergency Departments are treating an increasing number of geriatric trauma patients in the UK. Elderly patients, generally defined as those over the age of 65 years, are more susceptible to injury from lesser mechanisms of trauma than younger adults. The number of geriatric trauma cases is rising yearly, accounting for > 25% of all major trauma cases nationally. The elderly have different physiological reserves and a different response to trauma, due to premorbid frailty, co-existing conditions and prescribed medication...
March 6, 2018: British Journal of Radiology
Mwali Muray, Charles H Bélanger, Jamil Razmak
Purpose The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services. Design/methodology/approach The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables...
February 12, 2018: International Journal of Health Care Quality Assurance
Tony Rosen, Manish Shah, Nancy E Lundebjerg, Cynthia Singh, Melissa McMillian, Cathy C Sarli, Amy M Suiter, Andrew G Lee, John R Burton, Christopher R Carpenter
BACKGROUND: The Jahnigen Career Development Awards program was launched in 2002 with private funding and transformed into the Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR) program in 2011 through support from the National Institute on Aging and medical specialty professional societies. The Jahnigen / GEMSSTAR program has provided grants to early career physician-scientists from 10 surgical and related medical specialties to initiate and sustain research careers in the geriatric aspect of their discipline...
March 1, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jelle de Gelder, Jacinta A Lucke, Bas de Groot, Anne J Fogteloo, Sander Anten, Christian Heringhaus, Olaf M Dekkers, Gerard J Blauw, Simon P Mooijaart
OBJECTIVES: To study predictors of emergency department (ED) revisits and the association between ED revisits and 90-day functional decline or mortality. DESIGN: Multicenter cohort study. SETTING: One academic and two regional Dutch hospitals. PARTICIPANTS: Older adults discharged from the ED (N=1,093). MEASUREMENTS: At baseline, data on demographic characteristics, illness severity, and geriatric parameters (cognition, functional capacity) were collected...
February 28, 2018: Journal of the American Geriatrics Society
Yoel Gil, Yonit Well-Weiner, Tod Zalut, Reuven Friedmann, Amos M Yinnon, Eli Ben-Chetrit
Blood cultures' contamination (BCC) is associated with unnecessary processing of cultures, higher cost, and occasionally, unjustified antibiotic treatment. We aimed to reduce the rate of BCC by educational intervention. In parallel, we also strove to expand the use of aminoglycosides (AMG) and reduce the utilization of beta-lactam antibiotics. The rate of BCC was assessed prospectively in the study department - the Emergency Department (ED) and in control departments - Medical Departments A, B and Geriatrics...
February 2018: Harefuah
L Rouch, F Farbos, C Cool, C McCambridge, C Hein, S Elmalem, Y Rolland, B Vellas, P Cestac
OBJECTIVES: To evaluate the overall rate of adherence by general practitioners (GPs) to treatment modifications suggested at discharge from hospital and to assess the way communication between secondary and primary care could be improved. DESIGN: Observational prospective cohort study. SETTING: Patients hospitalized from the emergency department to the acute geriatric care unit of a university hospital. PARTICIPANTS: 206 subjects with a mean age of 85 years...
2018: Journal of Nutrition, Health & Aging
Chunyuan Qiu, Priscilla H Chan, Gary L Zohman, Heather A Prentice, Jessica J Hunt, Diana C LaPlace, Vu T Nguyen, Glenn R Diekmann, Gregory B Maletis, Vimal Desai
OBJECTIVES: To determine the impact of anesthesia type on in-hospital mortality and morbidity for geriatric fragility hip fracture surgery. DESIGN: Retrospective cohort study. SETTING: Integrates health care delivery system across 38 facilities in the United States. PATIENTS/PARTICIPANTS: We identified 16,695 patients 65 years of age and older who underwent emergent hip fracture repairs between 2009 and 2014 through the Kaiser Permanente hip fracture registry and excluded pathologic or bilateral fractures...
March 2018: Journal of Orthopaedic Trauma
Gabriella Bettelli
Universally recognized goals of preoperative anesthesia assessment are the evaluation of patient's health status to define the entity of the surgical risk, and the anticipation of possible complications while optimizing and planning preventive strategies. Data obtained by Comprehensive Geriatric Assessment (CGA) and frailty evaluation are of extreme usefulness in surgical risk evaluation in older patients and in the decision about surgery. It is from the team-based discussion of such results that the most appropriate treatment can be individuated, surgery invasiveness and duration critically analyzed and if needed modified, and the best perioperative strategy carefully tailored...
February 14, 2018: Aging Clinical and Experimental Research
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
Ha-Lim Jeon, Juhee Park, Euna Han, Dong-Sook Kim
Objective: To investigate the association between potentially inappropriate medicine (PIM) use, defined using the American Geriatric Society (AGS) 2012 Beers criteria, and the risk of hospitalization or emergency department (ED) visits in elderly patients, and to examine the most frequently used PIMs among patients with adverse outcomes. Design/Setting: This was a retrospective study using National Health Insurance claims data from 2010 to 2012. Intervention(s): Elderly patients who took PIMs are compared to those who were not taking PIMs...
February 1, 2018: International Journal for Quality in Health Care
Sinan Uluyol
Hemangiomas of the head and neck are common benign tumors usually in childhood. They are rarely seen in hard palate. The authors present a geriatric patient with abundant hemorrhage due to a capillary hemangioma of the hard palate. Management and treatment approaches of this rare, urgent, and life-threatening situation is discussed.
February 12, 2018: Journal of Craniofacial Surgery
Hong J Kan, Hadi Kharrazi, Bruce Leff, Cynthia Boyd, Ashwini Davison, Hsien-Yen Chang, Joe Kimura, Shannon Wu, Laura Anzaldi, Tom Richards, Elyse C Lasser, Jonathan P Weiner
BACKGROUND: Using electronic health records (EHRs), in addition to claims, to systematically identify patients with factors associated with adverse outcomes (geriatric risk) among older adults can prove beneficial for population health management and clinical service delivery. OBJECTIVE: To define and compare geriatric risk factors derivable from claims, structured EHRs, and unstructured EHRs, and estimate the relationship between geriatric risk factors and health care utilization...
March 2018: Medical Care
Hunter Singh Lau, Matthew M Hollander, Jeremy T Cushman, Eva H DuGoff, Courtney M C Jones, Amy J H Kind, Michael T Lohmeier, Eric A Coleman, Manish N Shah
OBJECTIVE: The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition...
February 12, 2018: Prehospital Emergency Care
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