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https://www.readbyqxmd.com/read/28212179/hard-choices-better-outcomes-a-review-of-shared-decision-making-and-patient-decision-aids-around-dialysis-initiation-and-conservative-kidney-management
#1
Janet L Davis, Sara N Davison
PURPOSE OF REVIEW: Patients reaching end-stage kidney disease face difficult decisions, including choosing among renal replacement therapies (RRTs). With an increasingly elderly and frail population, there is growing interest in conservative kidney management (CKM) as a viable alternative to dialysis. Shared decision-making (SDM) is a patient-centered approach to these decisions, in which choices are viewed within the explicitly discussed values and preferences of the patient. Patient decision aids (PDAs) are tools designed to facilitate these discussions...
February 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28198967/fall-and-its-association-with-the-frailty-syndrome-in-the-elderly-systematic-review-with-meta-analysis
#2
Jack Roberto Silva Fhon, Rosalina Aparecida Partezani Rodrigues, Wilmer Fuentes Neira, Violeta Magdalena Rojas Huayta, Maria Lucia do Carmo Cruz Robazzi
OBJECTIVE: To analyze the prevalence of falls and frailty syndrome and the association between these two syndromes in the elderly population. METHOD: Systematic review, without restriction of dates, in English, Portuguese and Spanish languages, in the databases PubMed, CINAHL, LILACS and in the SciElo virtual library. The association between both variables was extracted from the studies (Odds Ratio and 95% Confidence Intervals). RESULTS: The review included 19 studies published between 2001 and 2015...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28198946/chronic-pain-in-elderly-caregivers-at-different-levels-of-frailty
#3
Daiene de Morais, Mariélli Terassi, Keika Inouye, Bruna Moretti Luchesi, Sofia Cristina Iost Pavarini
Objective: To determine whether there are differences in the intensity of chronic pain of elderly caregivers who are frail, pre-frail and non-frail. Methods: Quantitative, descriptive and cross-sectional study. The subjects were 187 elderly caregivers evaluated with a Multidimensional Pain Assessment Scale and the Fried Frailty Phenotype Assessment Components. Descriptive and comparative analyzes, Pearson's chi-square test and Kruskal-Wallis test were used. Results: 24...
February 9, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28198686/severely-frail-elderly-patients-do-not-need-lipid-lowering-drugs
#4
REVIEW
Laurie Herzig Mallery, Paige Moorhouse, Pam McLean Veysey, Michael Allen, Isobel Fleming
After performing a systematic review, members of the Palliative and Therapeutic Harmonization (PATH) program and the Dalhousie Academic Detailing Service found that evidence does not support lipid-lowering therapy for severely frail elderly patients.
February 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28198684/statin-therapy-in-the-frail-elderly-a-nuanced-decision
#5
EDITORIAL
Donald Clark, Leslie S Cho
No abstract text is available yet for this article.
February 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28197996/upfront-lower-dose-lenalidomide-is-less-toxic-and-does-not-compromise-efficacy-for-vulnerable-patients-with-relapsed-refractory-multiple-myeloma-final-analysis-of-the-phase-ii-revlite-study
#6
Hang Quach, Liam Fernyhough, Ross Henderson, Gillian Corbett, Bart Baker, Peter Browett, Hilary Blacklock, Cecily Forsyth, Craig Underhill, Paul Cannell, Judith Trotman, Annette Neylon, Simon Harrison, Emma Link, Arlene Swern, Linda Cowan, Meletios A Dimopoulos, H Miles Prince
The combination of lenalidomide and dexamethasone is an established treatment for patients with multiple myeloma (MM). Increasingly, treatment attenuation is advocated for frail/elderly patients to minimize toxicity even though there have been no prospective studies to demonstrate whether lenalidomide dose attenuation impacts on response and survival outcome. This prospective multicentre phase II study assessed the efficacy and tolerability of lower dose lenalidomide (15 mg) and dexamethasone (20 mg) in 149 eligible patients with relapsed/refractory MM aged over 59 years and/or with renal impairment...
February 15, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28196784/addressing-palliative-care-clinician-burnout-in-organizations-a-workforce-necessity-an-ethical-imperative
#7
Krista L Harrison, Elizabeth Dzeng, Christine S Ritchie, Tait D Shanafelt, Arif H Kamal, Janet H Bull, Jon C Tilburt, Keith M Swetz
Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. This is especially problematic in hospice and palliative care: patients are often frail, elderly, vulnerable and complex; access to care is often outstripped by need; and demand for clinical experts will increase as palliative care further integrates into usual care. Efforts to mitigate and prevent burnout currently focus on individual clinicians...
February 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28195939/care-for-vulnerable-elderly-in-cardiology-a-program-for-daily-practice
#8
Mirjam A M Wit, Annet J C M Bos-Schaap, Victor A W M Umans
BACKGROUND: The percentage of cardiac patients aged ≥75 has increased considerably over the past decades. To optimize multidisciplinary care for these frail elderly, a program of intensive medical and nursing care was started at Noord West Ziekenhuisgroep department of cardiology. METHODS: Patients over 70 years of age, admitted to the department of cardiology, were included and treated by the advanced practice nurse according to a redesigned care process that focused on expedite mobilization and care by an advanced practice nurse-headed team including the first outpatient visit...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28195645/exploring-the-views-of-relatives-of-frail-elderly-patients-about-participating-in-a-geriatric-dentistry-program
#9
Diego Machado Ardenghi, Chris Wyatt
Elderly residents of long-term care facilities (LTC) have difficulty accessing dental services. Aiming to improve access for this population, the Geriatric Dental Program (GDP) was established by UBC Faculty of Dentistry in 2002. Within the GDP, elderly people receive fee-for-service dental care. The objective of this research was to explore whether accessing these services had an impact on the lives of the patients' relatives. Data was collected through semi-structured, face-to-face, audio-recorded interviews with family members of 12 GDP patients...
February 14, 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/28193213/a-case-report-of-spontaneous-umbilical-enterocutaneous-fistula-resulting-from-an-incarcerated-richter-s-hernia-with-a-brief-literature-review
#10
Wei Chen, Lei Liu, Hui Huang, Mianxu Jiang, Tao Zhang
BACKGROUND: Richter's hernia is a high-risk ischaemic gastrointestinal disorder that is typically diagnosed in a delayed manner due to a lack of obvious symptoms. Spontaneous umbilical enterocutaneous fistula (ECF) resulting from an incarcerated Richter's hernia is extremely rare. CASE PRESENTATION: A 62-year-old female presented with a chief complaint of recurrent umbilical region infection for the preceding 20 months with no symptoms of ileus. Preoperative CT and fistulography revealed an incarcerated Richter's hernia complicated by an ECF...
February 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28193134/non-coronary-vascular-calcification-bone-mineral-density-and-muscle-mass-in-institutionalized-frail-nonagenarians
#11
Fernando Idoate, Eduardo L Cadore, Alvaro Casas-Herrero, Fabricio Zambom-Ferraresi, Nicolas Martinez-Velilla, Leocadio Rodriguez-Mañas, Pedro M Azkarate, Martim Bottaro, Robison Ramírez-Vélez, Mikel Izquierdo
The purpose of this study was to compare the vascular calcification at thoracic (TAC) and ab-dominal (AAC) aorta, iliac (IAC) and femoral (FAC) arteries, and bone mineral density (BMD) of the lumbar vertebrae between frail and robust nonagenarians, as well as to verify the associations between vascular calcification with BMD, muscle tissue quality and quantity in both groups. Forty-two elderly subjects participated in this study: 29 institutionalized frail (92.0±3.2 years) and 13 ro-bust (89.0±4.0 years) elderly participants...
February 14, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28192477/impact-of-early-in-hospital-medication-review-by-clinical-pharmacists-on-health-services-utilization
#12
Corinne M Hohl, Nilu Partovi, Isabella Ghement, Maeve E Wickham, Kimberlyn McGrail, Lisa N Reddekopp, Boris Sobolev
BACKGROUND: Adverse drug events are a leading cause of emergency department visits and unplanned admissions, and prolong hospital stays. Medication review interventions aim to identify adverse drug events and optimize medication use. Previous evaluations of in-hospital medication reviews have focused on interventions at discharge, with an unclear effect on health outcomes. We assessed the effect of early in-hospital pharmacist-led medication review on the health outcomes of high-risk patients...
2017: PloS One
https://www.readbyqxmd.com/read/28186055/infosage-use-of-online-technologies-for-communication-and-elder-care
#13
Yuri Quintana, Bradley Crotty, Darren Fahy, Alex Orfanos, Ruchira Jain, Eli Kaldany, Lewis Lipsitz, Diane Engorn, Jorge Rodriguez, Frank Pandolfe, Adarsha Bajracharya, Warner V Slack, Charles Safran
Aging creates new information and communication needs for families who are helping to coordinate care for frail parents. To identify how information and communication needs evolve with the aging process, we created a living laboratory of families, supported by an online private social network with tools for care coordination. Site registrants are invite to participate in a more in-depth survey-based longitudinal study. In year one, we assessed the feasibility of an online living laboratory. During this first year, 155 individuals registered on InfoSAGE, and 26% opted into the more in-depth longitudinal study...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28181201/management-of-hypertension-in-the-elderly-and-frail-elderly
#14
REVIEW
Claudio Ferri, Livia Ferri, Giovambattista Desideri
An elevated systolic but not diastolic blood pressure level represents a common finding in elderly patients and is associated with an increased risk for developing coronary artery disease, cerebrovascular disease, peripheral artery disease, progressive cognitive decline and renal failure. Although less frequently, elderly patients manifest not only with systolic but also diastolic hypertension. Also in this case, the elderly patient will present an increased risk for developing hypertension-related abnormalities...
March 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28180932/-management-of-urinary-incontinence-in-a%C3%A2-geriatric-rehabilitation-department-global-urinary-incontinence-assessment-incorporating-the-international-consultation-on-incontinence-questionnare-urinary-incontinence-short-form-iciq-ui-sf
#15
Sigrid Ege
Although it is generally agree that older people have a high prevalence of urinary incontinence with a significant influence on health and quality of life, there is no standardized generally accepted assessment. The pathophysiology of urinary incontinence in frail elderly people requires a broad medical and functional scope to address the multifactorial nature of urinary incontinence, especially to identify treatable, potentially reversible conditions. To incorporate the multiple aspects into the daily routine, we developed a global urinary incontinence assessment at the Clinic for Geriatric Rehabilitation of the Robert Bosch Hospital including the validated International Consultation on Incontinence Questionnare - Urinary Incontinence Short Form (ICIQ-UI SF), a symptom score and results of a comprehensive geriatric assessment for mobility and cognition...
February 8, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28179337/mono-and-bi-weekly-hypofractionated-radiation-therapy-for-the-treatment-of-epithelial-skin-cancer-in-very-elderly-patients
#16
Maurizio Valeriani, Luca Nicosia, Linda Agolli, Chiara Reverberi, Emanuela Galvagno, Vitaliana DE Sanctis, Giuseppe Minniti, Marta Carlesimo, Mattia F Osti
BACKGROUND/AIM: Epithelial skin cancer frequently occurs in the elderly population, sometimes in an advanced stage, when intensive treatments are needed. Radiotherapy can achieve high response rates. We evaluated efficacy and tolerability of hypofractionated radiotherapy in a population of very elderly patients with locally advanced epithelial skin cancer. PATIENTS AND METHODS: Two different hypofractionated schedules were administered (21 patients): 6 Gy in 10 bi-weekly fractions (13 lesions) and 5 Gy in 12 bi-weekly fractions (13 lesions)...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28176523/glycomacropeptide-sustains-microbiota-diversity-and-promotes-specific-taxa-in-an-artificial-colon-model-of-elderly-gut-microbiota
#17
Alexandra Ntemiri, Fodhla Ni Chonchuir, Tom F O'Callaghan, Catherine Stanton, R Paul Ross, Paul W O'Toole
The potential of milk-derived glycomacropeptide (GMP) and lactose for modulating the human gut microbiota of older people, in whom loss of diversity correlates with inferior health, was investigated. We used an in vitro batch fermentation (artificial colon model) to simulate colonic fermentation processes of two GMP products, i.e. a commercially available GMP concentrate and a semi-purified GMP concentrate, and lactose. Faecal samples were collected from healthy and frail older people. Samples were analysed by Illumina Miseq sequencing of rRNA gene amplicons...
February 8, 2017: Journal of Agricultural and Food Chemistry
https://www.readbyqxmd.com/read/28168829/exploring-dental-student-participation-in-interdisciplinary-care-team-conferences-in-long-term-care
#18
Jeremy Huynh, Leeann R Donnelly, Mario A Brondani
OBJECTIVE: The purpose of this study was to explore how the participation of dental hygiene students in interdisciplinary care conferences conducted in long-term care (LTC) facilities influenced the staff's awareness of oral health, the student's provision of care as well as the student's ability to work on an interdisciplinary team. BACKGROUND: Oral health in LTC continues to be poor despite many educational and clinical interventions. The care of a frail elder requires an interdisciplinary team approach, yet dental professionals are often absent from these teams...
February 7, 2017: Gerodontology
https://www.readbyqxmd.com/read/28159059/the-association-between-anorexia-of-aging-and-physical-frailty-results-from-the-national-center-for-geriatrics-and-gerontology-s-study-of-geriatric-syndromes
#19
Kota Tsutsumimoto, Takehiko Doi, Hyuma Makizako, Ryo Hotta, Sho Nakakubo, Keitaro Makino, Takao Suzuki, Hiroyuki Shimada
OBJECTIVES: The present study examined the association between anorexia of aging and physical frailty among older people. STUDY DESIGN: An observational, cross-sectional cohort design was used with a sample of 4417 elderly Japanese citizens living in a community setting. MAIN OUTCOME MEASURES: Frailty was operationalized as the following frailty components: slowness, weakness, exhaustion, low level of physical activity, and weight loss. Participants were grouped as non-frail, pre-frail, and frail, and categorized as anorexic or not using questionnaire cutoff scores...
March 2017: Maturitas
https://www.readbyqxmd.com/read/28154088/a-concise-revised-myeloma-comorbidity-index-as-a-valid-prognostic-instrument-in-a-large-cohort-of-801-multiple-myeloma-patients
#20
Monika Engelhardt, Anne-Saskia Domm, Sandra Maria Dold, Gabriele Ihorst, Heike Reinhardt, Alexander Zober, Stefanie Hieke, Corine Baayen, Stefan Jürgen Müller, Hermann Einsele, Pieter Sonneveld, Ola Landgren, Martin Schumacher, Ralph Wäsch
With growing numbers of elderly multiple myeloma patients, reliable tools to assess their vulnerability are required. The objective of this analysis was to develop and validate an easy to use myeloma-risk-score (revised Myeloma Comorbidity Index) that allows risk prediction of OS and PFS differences in a large patient cohort. We conducted a geriatric assessment in 801 consecutive myeloma patients, including comorbidity risks obtained at diagnosis. The cohort was examined within a training and validation set...
February 2, 2017: Haematologica
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