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Geriatric orthopedics

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https://www.readbyqxmd.com/read/28444038/difficulties-in-accessing-services-that-are-of-medium-complexity-in-small-municipalities-a-case-study
#1
Camila Ribeiro Silva, Brigida Gimenez Carvalho, Luiz Cordoni, Elisabete de Fátima Pólo de Almeida Nunes
The study aimed to describe the specialized health services and to identify areas of greater difficulty of access to specialized consultations offered by SUS in small cities in the 18th Regional Health Area of Paraná State, Brazil, using case study methodology. The data were collected between January and April 2015. Managers, management teams and the board of directors of the CIS (Consórcio Intermunicipal de Saúde) were interviewed. The 21 studied specialist areas were rated like Sufficient Quota, Insufficient Quota, Inexistent Supply, and Assistance Gap...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#2
Laura C Lamb, Stephanie C Montgomery, Brian Wong Won, Siobhan Harder, Jeffrey Meter, James M Feeney
BACKGROUND: Fragility fractures have become a worldwide epidemic associated with significant morbidity and mortality. As the world population ages, the number of patients that experience these fractures is also expected to rise. A multidisciplinary team was assembled that was coordinated by the Acute Inpatient Medical Service and included orthopedic surgeons, geriatricians, anesthesiologists, cardiologists, nurses, trauma surgeons, emergency medicine physicians, physiatrists, and physical therapists...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28359364/age-dependent-risk-factors-for-malnutrition-in-traumatology-and%C3%A2-orthopedic-patients
#3
Christine Lambert, Andreas Nüssler, Hans Konrad Biesalski, Thomas Freude, Christian Bahrs, Gunnar Ochs, Ingo Flesch, Ulrich Stöckle, Christoph Ihle
OBJECTIVE: The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM. METHODS: The prospective cohort study included 1053 patients in a level 1 trauma center in Germany...
May 2017: Nutrition
https://www.readbyqxmd.com/read/28255509/palliative-management-of-nonoperative-femoral-neck-fractures-with-continuous-peripheral-pain-catheters-20-patient-case-series
#4
Christopher H Rashidifard, Nicholas M Romeo, Paul Muccino, Mark Richardson, Thomas G DiPasquale
INTRODUCTION: To identify the success of pain catheters in the management of pain in nonoperatively treated femoral neck fractures (FNFs) in supplement to current multimodal protocols for end-of-life pain management. METHODS: Twenty patients aged older than 50 years with FNFs were selected in a retrospective fashion at a level 1 trauma center. These patients were treated nonoperatively with indwelling continuous peripheral pain catheters to palliate pain. Adjunctive pain control for patients undergoing nonoperative management of FNFs was provided with an indwelling continuous intra-articular/peripheral nerve ropivacaine pain catheters...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28149067/wholistic-orthopedics-is-this-the-right-way-to-treat-geriatric-orthopedic-patients
#5
John Ebnezar, Yogita Bali, Rakesh John
Geriatric orthopedic problems poses different challenges in their management. Conventional treatment methods like drugs, physiotherapy and surgeries are inadequate. A Geriatric orthopedic patient suffers as a whole and not in isolation. This article highlights the importance of managing geriatric orthopedic patients as a whole and outlines the various steps of wholistic management.
January 2017: International Journal of Yoga
https://www.readbyqxmd.com/read/28087218/relationship-among-motor-function-adl-disability-and-psychological-concerns-in-elderly-people-with-locomotive-disorders
#6
Toshiyuki Miyawaki, Keigo Kumamoto, Kaori Shimoda, Fusae Tozato, Tsutomu Iwaya
BACKGROUND: Locomotive disorders are one of the main causative pathologies for the condition requiring assistance on activities of daily living (ADL). Although psychological concerns such as feeling of depression and anxiety are prevalent in elderly people, the causal relation among motor function, ADL disability, and psychological concerns is controversial. PURPOSE: Purpose of this study was to investigate causal relationship among motor function, ADL disability, and psychological concerns in elderly people with locomotive disorders...
January 10, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28025357/deconstructing-chronic-low-back-pain-in-the-older-adult-step-by-step-evidence-and-expert-based-recommendations-for-evaluation-and-treatment-part-xii-leg-length-discrepancy
#7
Mark Havran, Joel D Scholten, Paula Breuer, Jennifer Lundberg, Gary Kochersberger, Dave Newman, Debra K Weiner
 To present the last in a 12-part series designed to deconstruct chronic low back pain (CLBP) in older adults. This article focuses on leg length discrepancy (LLD) and presents an algorithm outlining approaches to diagnosis and management of LLD in older adults, along with a representative clinical case. METHODS : Using a modified Delphi approach, the LLD evaluation and treatment algorithm was developed by a multidisciplinary expert panel representing expertise in physical therapy, geriatric medicine, and physical medicine and rehabilitation...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27999879/-perioperative-patient-management-in-orthogeriatrics
#8
P Moldzio, J Peters
The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general...
January 2017: Der Orthopäde
https://www.readbyqxmd.com/read/27942737/prothrombin-complex-concentrates-an-alternative-to-fresh-frozen-plasma
#9
David R Burk, Jordan L Smith, Jason R Wild
Insufficiency fractures are a common cause of morbidity among geriatric patients worldwide. Improved outcomes are known to result from decreased delay to definitive operative fixation and mobilization. Use of warfarin is an important potential cause of delay. The ideal mode of warfarin reversal is currently unknown. Prothrombin complex concentrates (PCCs) offer rapid correction with small infusion volume, both of which are important for elderly patients with multiple comorbidities. The authors present 2 cases of insufficiency fractures occurring in geriatric patients receiving warfarin therapy reversed with a 3-factor PCC...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#10
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
December 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27747924/results-of-screening-of-apparently-healthy-senior-and-geriatric-dogs
#11
A Willems, D Paepe, S Marynissen, P Smets, I Van de Maele, P Picavet, L Duchateau, S Daminet
BACKGROUND: There is a growing interest in health care of elderly dogs; however, scientific information about physical and laboratory examination findings in this age group is limited. OBJECTIVES: To describe systolic blood pressure (SBP), and results of physical examination and laboratory tests in senior and geriatric dogs that were judged by the owner to be healthy. ANIMALS: Hundred client-owned dogs. METHODS: Dogs were prospectively recruited...
January 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/27678211/frailty-and-resilience-in-an-older-population-the-role-of-resilience-during-rehabilitation-after-orthopedic-surgery-in-geriatric-patients-with-multiple-comorbidities
#12
G A A Rebagliati, L Sciumè, P Iannello, A Mottini, A Antonietti, V A Caserta, V Gattoronchieri, Lorenzo Panella, Camilla Callegari
Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb...
July 2016: Functional Neurology
https://www.readbyqxmd.com/read/27546959/lower-limb-orthopedic-surgery-in-geriatric-patients-under-paravertebral-blocks-a-prospective-feasibility-study
#13
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27430902/-delirium-day-a-nationwide-point-prevalence-study-of-delirium-in-older-hospitalized-patients-using-an-easy-standardized-diagnostic-tool
#14
MULTICENTER STUDY
Giuseppe Bellelli, Alessandro Morandi, Simona G Di Santo, Andrea Mazzone, Antonio Cherubini, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi
BACKGROUND: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy...
July 18, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27409710/association-of-loss-of-independence-with-readmission-and-death-after-discharge-in-older-patients-after-surgical-procedures
#15
Julia R Berian, Sanjay Mohanty, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
IMPORTANCE: Older adults are at increased risk for adverse events after surgical procedures. Loss of independence (LOI), defined as a decline in function or mobility, increased care needs at home, or discharge to a nonhome destination, is an important patient-centered outcome measure. OBJECTIVE: To evaluate LOI among older adult patients after surgical procedures and examine the association of LOI with readmission and death after discharge in this population. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study examined 9972 patients 65 years and older with known baseline function, mobility, and living situation undergoing inpatient operations from January 2014 to December 2014 at 26 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program Geriatric Surgery Pilot Project...
September 21, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27257439/assessment-of-recovery-in-older-patients-hospitalized-with-different-diagnoses-and-functional-levels-evaluated-with-and-without-geriatric-assessment
#16
Jenny Foss Abrahamsen, Cathrine Haugland, Anette Hylen Ranhoff
BACKGROUND: The objective of the present study was to investigate 1) the role of different admission diagnoses and 2) the degree of functional loss, on the rate of recovery of older patients after acute hospitalization. Furthermore, to compare the predictive value of simple assessments that can be carried out in a hospital lacking geriatric service, with assessments including geriatric screening tests. METHODS: Prospective, observational cohort study, including 961community dwelling patients aged ≥ 70 years, transferred from medical, cardiac, pulmonary and orthopedic acute hospital departments to intermediate care in nursing home...
2016: European Review of Aging and Physical Activity
https://www.readbyqxmd.com/read/27231388/prognostic-value-of-serum-procalcitonin-after-orthopedic-surgery-in-the-elderly-population
#17
Hélène Vallet, Camille Chenevier-Gobeaux, Cédric Villain, Judith Cohen-Bittan, Patrick Ray, Loïc Epelboin, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Background: Orthopedic surgery is more and more frequent in the older patients and is associated with a high mortality rate. Although serum procalcitonin levels are associated with prognosis in young adults, data are still lacking in the elderly population, and especially after surgery. The main objective of this study was to determine the prognostic value of procalcitonin levels in a large geriatric orthopedic population, and we compared it with clinical variables and biomarkers. Methods: This is a prospective study including patients admitted in our dedicated geriatric postoperative unit, after orthopedic surgery with immediate postoperative measured procalcitonin levels...
March 1, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/27125080/complex-management-of-frailty-fractures-case-report
#18
Elena Puin Costescu, Aliona Dronic, Loana Dana Alexa, O Alexa
Frailty fractures encompass pelvic ring fractures in the elderly--a condition more frequently encountered in women, usually with pre-existing osteoporosis. The incidence of these fractures is increasing, following the increase in average life expectancy. Most of the times, they are the result of a minor injury, of which the patient has little or no recollection; the clinical signs and symptoms, radiological changes and the degree of fracture stability vary greatly. As such, there is a wide range of therapeutic options and one of the most important decisions for the physician is choosing between surgery and conservative treatment...
January 2016: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
https://www.readbyqxmd.com/read/26929852/do-orthogeriatric-inpatients-have-a-correct-medication-list-a-pharmacist-led-assessment-of-254-patients-in-a-swedish-university-hospital
#19
Olof Wolf, Henrik Åberg, Ulrika Tornberg, Kenneth B Jonsson
INTRODUCTION: Comorbidities and polypharmacy complicate the treatment of geriatric patients with acute orthopedic injuries. A correct medication history and an updated medication list are a prerequisite for safe treatment of these debilitated patients. Published evidence suggests favorable outcomes with comanaged care. The aim of this study was to assess the accuracy of the inpatient medication lists generated at admission and investigate the efficacy of a dedicated ward-based pharmacist to find and correct mistakes in these lists...
March 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/26928617/-hip-fracture-experience-in-647-chilean-patients-aged-60-years-or-more
#20
José Luis Dinamarca-Montecinos, Gedeón Améstica-Lazcano, Ramona Rubio-Herrera, Alejandro Carrasco-Buvinic, Alejandra Vásquez
BACKGROUND: Hip fractures (HFx) are an important geriatric syndrome, with a high incidence in developing countries. AIM: To describe characteristics of a group of Chilean patients with HFx. PATIENTS AND METHODS: In a cross-sectional study we included patients aged 60 years or more with a HF admitted to an orthopedic service along three years. Age, incidence, location, seasonality, hospital stay, time between HFx and surgery, mortality, prior treatment for osteoporosis, anatomical location, etiology and type of surgery were evaluated...
December 2015: Revista Médica de Chile
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