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https://www.readbyqxmd.com/read/27910810/production-of-tnf-alpha-ex-vivo-is-predictive-of-an-immune-response-to-flu-vaccination-in-a-frail-elderly-population
#1
Frédéric Bloch, Bénédicte Charmeteau, Michael Tovey, Jean-François Meritet, Corinne Desaint, Odile Launay, Pierre Lebon
OBJECTIVE: To investigate the relationship between the response to influenza vaccination and the ability to produce proinflamatory cytokines in elderly subjects. METHODS: Whole blood samples from 25 elderly subjects collected before influenza vaccination were stimulated with the influenza vaccine in order to evaluate the secretion of five specific cytokines: TNFα, IFNα, IFNγ, IL2 and IL10. The results were correlated with the increased HAI antibody titres two weeks after vaccination...
September 1, 2016: European Cytokine Network
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#2
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#3
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27896484/oral-health-status-and-need-for-oral-care-of-care-dependent-indwelling-elderly-from-admission-to-death
#4
Arie R Hoeksema, Lilian L Peters, Gerry M Raghoebar, Henny J A Meijer, Arjan Vissink, Anita Visser
OBJECTIVES: The objective of this study is to assess oral health and oral status of elderly patients newly admitted to a nursing home from admission until death. MATERIALS AND METHODS: Oral health, oral status, need for dental care, cooperation with dental treatment, and given dental care were assessed by two geriatric dentists in all new long-stay patients (n = 725) admitted to a nursing home between January 2009 and December 2013. All patients were followed from admission until death or until they left the nursing home...
November 28, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27890581/total-hip-arthroplasty-using-a-cementless-dual-mobility-cup-provides-increased-stability-and-favorable-gait-parameters-at-five-years-follow-up
#5
A Acker, J-F Fischer, K Aminian, E Lécureux, B M Jolles
BACKGROUND: Rates of dislocation following primary total hip arthroplasty (THA) vary from 0.5 to 10%. Dual-mobility cups in THA demonstrate increased stability. Clinical outcomes following THA with dual-mobility cups have been reported, but gait has not been assessed. Therefore we performed a retrospective case control study to answer: (1) is gait better in patients following THA with a dual-mobility cup than in frail, elderly patients of the same age? (2) Are clinical outcomes better in patients following THA with a dual-mobility cup than in frail, elderly patients? (3) What is the dislocation rate following THA with a dual-mobility cup? HYPOTHESIS: We hypothesized that patients who underwent THA with a dual-mobility cup have a better gait compared to frail, elderly patients of the same age...
November 24, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27884857/implementing-shared-decision-making-in-interprofessional-home-care-teams-the-ipsdm-sw-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#6
France Légaré, Nathalie Brière, Dawn Stacey, Guy Lacroix, Sophie Desroches, Serge Dumont, Kimberly D Fraser, Louis-Paul Rivest, Pierre J Durand, Stéphane Turcotte, Monica Taljaard, Henriette Bourassa, Lise Roy, Geneviève Painchaud Guérard
INTRODUCTION: The frail elderly in Canada face a tough decision when they start to lose autonomy: whether to stay at home or move to another location. This study seeks to scale up and evaluate the implementation of shared decision-making (SDM) in interprofessional (IP) home care teams caring for elderly clients or their caregivers facing a decision about staying at home or moving elsewhere. METHODS: A stepped wedge cluster randomised trial involving 8 Health and Social Service Centers (HSSCs) will be conducted with IP home care teams...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27883315/the-need-for-accurate-risk-prediction-models-for-road-mapping-shared-decision-making-and-care-planning-for-the-elderly-with-advanced-chronic-kidney-disease
#7
Marijke Stryckers, Evi V Nagler, Wim Van Biesen
As people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual's values and preferences. Accurate estimations of one's risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27882453/-implementation-of-a%C3%A2-proactive-integrated-primary-care-program-for-frail-older-people-from-science-to-evidence-based-practice
#8
Nienke Bleijenberg, Artine de Jonge, Morris P Brand, Caitriona O'Flynn, Marieke J Schuurmans, Niek J de Wit
BACKGROUND: Multimorbidity, functional impairment and frailty among community-dwelling older people are causing increasing complexity in primary care. A proactive integrated primary care approach is therefore essential. Between October 2014-2015, an evidence-based proactive care program for frail older people was implemented in the region Noord-West Veluwe en Zeewolde, the Netherlands. This study evaluated the feasibility of the implementation, having a strong focus on the collaboration between the medical and social domain...
December 2016: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/27881697/adult-day-services-outcomes-delphi-review-of-an-integrated-participant-assessment-system
#9
Shannon Jarrott, Aaron M Ogletree
Adult day services (ADS) aim to help elders age in place, but evidence of impact on participants lags behind caregiver research. To play a larger role in the continuum of care, ADS participant outcomes should regularly be documented with standard measures. We conducted a Delphi review of one integrated participant assessment system. Capturing physical, mental, and cognitive health indicators and activity engagement of typical ADS participants (i.e., frail elders eligible for nursing home placement), experts evaluated the system on instrument validity, relevance, and application...
November 22, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
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...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27855641/development-and-validation-of-the-fragire-tool-for-assessment-an-older-person-s-risk-for-frailty
#11
Dewi Vernerey, Amelie Anota, Pierre Vandel, Sophie Paget-Bailly, Michele Dion, Vanessa Bailly, Marie Bonin, Astrid Pozet, Audrey Foubert, Magdalena Benetkiewicz, Patrick Mankoundia, Franck Bonnetain
BACKGROUND: Frailty is highly prevalent in elderly people. While significant progress has been made to understand its pathogenesis process, few validated questionnaire exist to assess the multidimensional concept of frailty and to detect people frail or at risk to become frail. The objectives of this study were to construct and validate a new frailty-screening instrument named Frailty Groupe Iso-Ressource Evaluation (FRAGIRE) that accurately predicts the risk for frailty in older adults...
November 17, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27845703/older-swedish-adults-with-high-self-perceived-health-show-optimal-25-hydroxyvitamin-d-levels-whereas-vitamin-d-status-is-low-in-patients-with-high-disease-burden
#12
Martin Carlsson, Pär Wanby, Lars Brudin, Erik Lexne, Karin Mathold, Rebecca Nobin, Lisa Ericson, Ola Nordqvist, Göran Petersson
Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH)D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH)D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people ≥75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy...
November 11, 2016: Nutrients
https://www.readbyqxmd.com/read/27827291/-general-practitioner-and-specialist-elderly-care-medicine-paramount-a-strong-pairing-in-the-care-of-the-vulnerable-elderly
#13
C M P M Verheugt, J F Bastiaans
The Dutch National Care for the Elderly Programme (NPO) was launched as a large-scale project, in which screening for vulnerability, followed by a comprehensive geriatric assessment, played an important role. An oft-cited explanation for the poor effects of the NPO projects is the high quality of Dutch primary care. However, the complexity of frail elderly care raises the question as to whether the competence of a nurse or practice nurse is sufficient to ensure proper care and treatment. Moreover, studies used vulnerability as a risk status, as if vulnerability were reversible...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27824980/the-role-of-digitization-in-the-rapid-reproduction-of-an-obturator-in-a-frail-elderly-patient
#14
Mahmoud E Elbashti, Yuka I Sumita, Mariko Hattori, Amel M Aswehlee, Hisashi Taniguchi
This case report describes the reproduction of the current obturator of a frail elderly patient using the digitization concept. A computed tomography scanner was used to scan the obturator. The virtual model was created using three-dimensional modeling software. The model was printed using a plastic with a low melting point with a fused deposition modeling technique in a three-dimensional printer and then conventionally processed. The definitive obturator was inserted and evaluated for fit, function, and esthetics and was successfully delivered at the second visit...
November 2016: International Journal of Prosthodontics
https://www.readbyqxmd.com/read/27823899/influenza-vaccination-and-the-endurance-against-air-pollution-among-elderly-with-acute-coronary-syndrome
#15
Ching-Hui Huang, Day-Yu Chao, Chao-Chun Wu, Shu-Yun Hsu, Maw-Soan Soon, Chia-Chu Chang, Chew-Teng Kor, Wan-Tzu Chang, Ie-Bin Lian
OBJECTIVE: Air pollution, weather condition and influenza are known risk factors of acute coronary syndrome (ACS) among elderly people. The influenza vaccine (IV) has been shown to reduce major cardiovascular events. The purpose of this study was to compare resistance to air pollution and weather factors causing ACS between vaccinated and less-vaccinated elderly people. METHODS: A case-crossover design was applied to 1835 elderly ACS patients who were obtained from the 1-million sample of Taiwan National Health Insurance Research Data with inclusion criteria: (1) the first diagnosis of ACS was in cold season and at age 68 or more, (2) had received the free IV program at least once during the period 3years before the ACS...
December 7, 2016: Vaccine
https://www.readbyqxmd.com/read/27807536/specific-aspects-of-breast-cancer-therapy-of-elderly-women
#16
REVIEW
Petra Tesarova
Breast cancer is the leading cause of death among women, and its incidence increases with age. The average age at diagnosis is 61 years, and the majority of deaths occurs after the age of 65 years. Optimal approach to elderly women with breast cancer is still a major challenge. Elderly patients with cancer should have at least a brief geriatric assessment to detect potentially treatable problems not always adequately evaluated by the oncologists. Therapeutic nihilism should be avoided and effective treatment provided, unless there are compelling reasons against it...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27790675/management-of-skin-cancer-in-the-frail-elderly-time-for-a-rethink
#17
EDITORIAL
J K Schofield, E Linos, J Callander
No abstract text is available yet for this article.
November 2016: British Journal of Dermatology
https://www.readbyqxmd.com/read/27785425/how-to-optimally-manage-elderly-bladder-cancer-patients
#18
REVIEW
Francesco Soria, Marco Moschini, Stephan Korn, Shahrokh F Shariat
Bladder cancer (BCa) is a disease of the elderly and as the population is aging, BCa will become an even bigger public health challenge in the future. Nowadays the correct management of BCa in the elderly remains controversial. The purpose of this article was to review the previous literature to summarize the current knowledge. Using Medline, a non-systematic review was performed including articles between January 2000 and February 2016 in order to describe the management of BCa in the elderly in all its aspects...
October 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/27781968/-complex-interventions-in-elderly-how-do-we-determine-the-effect
#19
A R Koffeman
The care for frail elderly is challenging and requires an individualised approach. To meet the complex care needs of these patients, interventions aimed at improving care often consist of multiple interacting components. Several recent RCTs investigating such complex interventions in a primary care setting were unable to show an effect. In this paper the challenges that arise when examining complex interventions in experimental trials are discussed. Standardisation of the content of the intervention is often not desirable...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27773426/peritoneal-or-hemodialysis-for-the-frail-elderly-patient-the-choice-of-2-evils
#20
Edwina A Brown, Frederic O Finkelstein, Osasuyi U Iyasere, Alan S Kliger
Management of older people on dialysis requires focus on the wider aspects of aging as well as dialysis. Almost all frail and older patients receiving dialysis will default to in-center hemodialysis, although the availability of assisted peritoneal dialysis enables dialysis at home. As with any disease management decision, patients approaching end-stage renal disease need all the appropriate facts about their prognosis, the natural history of their disease without dialysis, and the resulting outcomes and complications of the different dialysis modalities...
October 20, 2016: Kidney International
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