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Geriatric emergencies

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https://www.readbyqxmd.com/read/28728613/echocardiographic-parameters-of-clinically-normal-geriatric-rhesus-macaques-macacamulatta
#1
Yu Ueda, Catherine T Gunther-Harrington, Christina L Cruzen, Jeffrey A Roberts, Joshua A Stern
The goal of this study was to generate reference intervals for echocardiographic variables in a population of clinically normal geriatric rhesus macaques (Macaca mulatta). To do this, we studied 51 animals (age, 18-29 y; weight, 5.24-17.04 kg). The normal values for cardiac indices, including geometry and systolic and diastolic function, were determined by 2D, M-mode, spectral Doppler, and tissue Doppler echocardiography under ketamine hydrochloride sedation. Statistical correlations between the echocardiographic parameters and age, body weight, sex, and heart rate were investigated...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28724484/echocardiographic-parameters-of-clinically-normal-geriatric-rhesus-macaques-macacamulatta
#2
Yu Ueda, Catherine T Gunther-Harrington, Christina L Cruzen, Jeffrey A Roberts, Joshua A Stern
The goal of this study was to generate reference intervals for echocardiographic variables in a population of clinically normal geriatric rhesus macaques (Macaca mulatta). To do this, we studied 51 animals (age, 18-29 y; weight, 5.24-17.04 kg). The normal values for cardiac indices, including geometry and systolic and diastolic function, were determined by 2D, M-mode, spectral Doppler, and tissue Doppler echocardiography under ketamine hydrochloride sedation. Statistical correlations between the echocardiographic parameters and age, body weight, sex, and heart rate were investigated...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
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/28717779/impact-of-middle-east-respiratory-syndrome-outbreak-on-the-use-of-emergency-medical-resources-in-febrile-patients
#4
Hyunho Jeong, Sikyoung Jeong, Juseok Oh, Seon Hee Woo, Byung Hak So, Jeong Hee Wee, Ji Hoon Kim, Ji Yong Im, Seung Pill Choi, Kyoungnam Park, Byul Nim Hee Cho, Sungyoup Hong
OBJECTIVE: Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. METHODS: An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28683706/sarcopenia-what-should-a-pharmacist-know
#5
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/28675571/five-year-survival-after-surgery-in-nonagenarian-patients
#6
Roberto Fariña-Castro, Cristina Roque-Castellano, Joaquín Marchena-Gómez, Aurelio Rodríguez-Pérez
AIM: In countries with longer life expectancies, the nonagenarian population is increasing. Therefore, there is greater demand for healthcare, including surgical procedures. The aim of the present study was to determine the outcomes of surgery carried out on nonagenarians in terms of long-term survival after the procedure. METHODS: We carried out a cross-longitudinal study on a cohort of 159 nonagenarian patients, who underwent a non-cardiac, non-traumatic surgical procedure in our institution between January 1999 and December 2011...
July 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28636480/the-emerging-role-of-pimavanserin-in-the-management-of-parkinson-s-disease-psychosis
#7
Neal Hermanowicz, Gustavo Alva, Fernando Pagan, Alberto J Espay, Amita Patel, Katya Cruz Madrid, Daniel Kremens, Jim Kenney, Sheila Arquette, Gary Tereso, Maria Lopes, Carolyn Farnum
A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key points emerged from the discussion: (1) Because of the nature of Parkinson's disease and PDP, finding appropriate treatment can prove challenging; (2) emerging therapies may present an opportunity for effective disease management; and (3) moving forward, provider and patient education regarding PDP and available treatment options is essential for well-managed symptoms and better quality of life...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#8
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28626877/factors-associated-with-the-difficulty-in-hospital-acceptance-among-elderly-emergency-patients-a-population-based-study-in-osaka-city-japan
#9
Tasuku Matsuyama, Tetsuhisa Kitamura, Yusuke Katayama, Kosuke Kiyohara, Sumito Hayashida, Takashi Kawamura, Taku Iwami, Bon Ohta
AIM: We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients. METHODS: We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals...
June 18, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28623658/echocardiographic-parameters-of-clinically-normal-geriatric-rhesus-macaques-macaca-mulatta
#10
Yu Ueda, Catherine T Gunther-Harrington, Christina L Cruzen, Jeffrey A Roberts, Joshua A Stern
The goal of this study was to generate reference intervals for echocardiographic variables in a population of clinically normalgeriatric rhesus macaques (Macaca mulatta). To do this, we studied 51 animals (age, 18-29 y; weight, 5.24-17.04 kg). Thenormal values for cardiac indices, including geometry and systolic and diastolic function, were determined by 2D, M-mode,spectral Doppler, and tissue Doppler echocardiography under ketamine hydrochloride sedation. Statistical correlations betweenthe echocardiographic parameters and age, body weight, sex, and heart rate were investigated...
June 16, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28621015/perturbation-based-balance-training-for-falls-reduction-among-older-adults-current-evidence-and-implications-for-clinical-practice
#11
REVIEW
Marissa H G Gerards, Christopher McCrum, Avril Mansfield, Kenneth Meijer
Falls are a leading cause of injury, hospitalization and even death among older adults. Although various strength and balance exercise interventions have shown moderate reductions in falls incidence among healthy older adults, no significant falls incidence improvements have been consistently seen in frail older adults or in patient groups with an increased falls risk (e.g. people with Parkinson's disease and stroke). This might be due to a lack of task specificity of previous exercise interventions to the recovery actions required to prevent a fall...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#12
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28611877/emergency-department-pain-management-following-implementation-of-a-geriatric-hip-fracture-program
#13
Scott D Casey, Dane E Stevenson, Bryn E Mumma, Christina Slee, Philip R Wolinsky, Calvin H Hirsch, Katren Tyler
INTRODUCTION: Over 300,000 patients in the United States sustain low-trauma fragility hip fractures annually. Multidisciplinary geriatric fracture programs (GFP) including early, multimodal pain management reduce morbidity and mortality. Our overall goal was to determine the effects of a GFP on the emergency department (ED) pain management of geriatric fragility hip fractures. METHODS: We performed a retrospective study including patients age ≥65 years with fragility hip fractures two years before and two years after the implementation of the GFP...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28610755/epistemological-erasure-the-subject-of-abuse-in-the-problematization-of-elder-abuse
#14
Bridget Garnham, Lia Bryant
The academic field of literature pertaining to elder abuse emerges largely from gerontology with contributions from a variety of disciplines including geriatric medicine, nursing, public health, law, psychology, sociology and social work. This paper presents a critical review of articles drawn from this literature to identify current directions leading the development of empirical research in this field. The objective measurement of prevalence, the identification and correlation of psycho-social risk factors and practice-based research oriented to intervention and prevention are identified as privileged sites for scientific investigation...
April 2017: Journal of Aging Studies
https://www.readbyqxmd.com/read/28595947/comparison-of-temporal-artery-versus-rectal-temperature-in-emergency-department-patients-who-are-unable-to-participate-in-oral-temperature-assessment
#15
Carmen Brosinski, Sherwin Valdez, Autumn Riddell, Robert H Riffenburgh
INTRODUCTION: In the emergency department, pediatric and geriatric patients who present with illnesses and are unable to participate in oral evaluation of temperature must undergo a rectal temperature (RT) assessment. This study asks if a temporal artery temperature (TAT) measure can supplant the RT measure. METHODS: A convenience sample, using a within-subject design, was used to evaluate the efficacy of TAT compared with RT in patients ≤ 3 and ≥ 65 years of age, who were unable to participate in oral temperature assessments...
June 5, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28595529/development-and-optimization-by-quality-by-design-strategies-of-frovatriptan-orally-disintegrating-tablets-for-migraine-management
#16
Natascia Mennini, Serena Orlandini, Sandra Furlanetto, Benedetta Pasquini, Paola Mura
BACKGROUND: Frovatriptan is a potent anti-migraine agent with unfavourable slow onset of action, available on the market as film-coated tablets. OBJECTIVE: optimization, by Quality by Designs strategies, of an orally disintegrating tablet (ODT) formulation of frovatriptan aimed to make its oral administration easier and its dissolution faster than the commercial tablets, thus improving its effectiveness in migraine management. METHOD: A screening D-optimal design was applied to investigate the effects of different levels of kind and amount of ODT special excipient and disintegrant agents (identified as the critical variables) on disintegration time (DT) and % drug dissolved at 30 s (%Diss), selected as the responses to optimize...
June 5, 2017: Current Drug Delivery
https://www.readbyqxmd.com/read/28586939/-urgent-visits-to-nursing-homes-a-general-practitioner-s-perspective
#17
Markus Bleckwenn, David Ashrafnia, Rieke Schnakenberg, Klaus Weckbecker
Aim of the study Due to demographic changes, home visits to nursing care facilities are increasing. Urgent home visits represent a challenge for general practitioners. There are no recommendations for the implementation of urgent home visits. Therefore, in this study, we investigated how GP practices deal with urgent home visits and what improvements can be made to the medical emergency care. Methods A total of 15 teaching doctors of the Department of Family Medicine at the University of Bonn were interviewed using semi-structured interviews on the subject...
June 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#18
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28583833/profile-and-results-of-frail-patient-assessed-by-advanced-practice-nursing-in-an-emergency-department
#19
Montserrat Solé-Casals, Emilia Chirveches-Pérez, Emma Puigoriol-Juvanteny, Núria Nubó-Puntí, Carolina Chabrera-Sanz, Mireia Subirana-Casacuberta
OBJECTIVES: To describe the profile of patients evaluated by Nurse Care Management in an Emergency Department and identify the type of alternative healthcare resource assigned and report the results of clinical practice. MATERIAL AND METHODS: Prospective follow-up, on admission to the Emergency Department in an acute hospital and on discharge from the alternative healthcare resource, of patients assessed by Nurse Care Management, from July to December 2015. The patient characteristics, social environment and results of clinical practice were studied...
June 2, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28581701/mini-nutritional-assessment-short-form-as-a-useful-method-of-predicting-poor-1-year-outcome-in-elderly-patients-undergoing-orthopedic-surgery
#20
Che-Sheng Chu, Chih-Kuang Liang, Ming-Yueh Chou, Ti Lu, Yu-Te Lin, Chin-Liang Chu
AIM: The present study aimed to determine whether the Mini-Nutritional Assessment Short-Form (MNA-SF) can predict the 1-year outcome of orthopedic fracture surgery in elderly patients. METHODS: This 1-year prospective study assessed nutrition using the MNA-SF at baseline, and postoperatively at 6 and 12 months. Repeated measures analysis of covariance was used to examine functional change over time for two MNA-SF categories. Multivariable logistic regression analysis with forward stepwise modeling was carried out to identify risk factors of functional decline, emergency department visit, hospital readmission and mortality at follow up...
June 5, 2017: Geriatrics & Gerontology International
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