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James W Behan, Adam Sutton, Ashley Wysong
Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression...
December 2016: Current Treatment Options in Oncology
Benedict U Nwachukwu, Kara Fields, Brenda Chang, Danyal H Nawabi, Bryan T Kelly, Anil S Ranawat
BACKGROUND: There is increasing interest in defining meaningful improvement in patient-reported outcomes. Knowledge of the thresholds and determinants for successful femoroacetabular impingement (FAI) outcomes is evolving. PURPOSE: To define preoperative outcome score thresholds and determine clinical/demographic patient factors predictive for achieving the minimal clinically important difference (MCID) after arthroscopic FAI surgery. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2...
October 20, 2016: American Journal of Sports Medicine
Ling Na, Sean Hennessy, Hillary R Bogner, Jibby E Kurichi, Margaret Stineman, Joel E Streim, Pui L Kwong, Dawei Xie, Liliana E Pezzin
BACKGROUND: Receipt of recommended care among older adults is generally low. Findings regarding service use among persons with disabilities supports the notion of disparities but provides inconsistent evidence of underuse of recommended care. OBJECTIVE: To examine the extent to which receipt of recommended care among older Medicare beneficiaries varies by disability status, using a newly developed staging method to classify individuals according to disability. METHODS: In a cohort study, we included community-dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Current Beneficiary Survey between 2001 and 2008...
October 4, 2016: Disability and Health Journal
Kenichiro Kakutani, Yoshitada Sakai, Koichiro Maeno, Toru Takada, Takashi Yurube, Takuto Kurakawa, Shingo Miyazaki, Yoshiki Terashima, Masaaki Ito, Hitomi Hara, Teruya Kawamoto, Yasuo Ejima, Akihiro Sakashita, Naomi Kiyota, Yoshiyuki Kizawa, Ryohei Sasaki, Toshihro Akisue, Hironobu Minami, Ryosuke Kuroda, Masahiro Kurosaka, Kotaro Nishida
STUDY DESIGN: A prospective cohort study of performance status (PS) and activities of daily living (ADL) in patients with spinal metastasis. OBJECTIVE: To identify the effect of spinal surgery on PS and ADL in patients with spinal metastasis. SUMMARY OF BACKGROUND DATA: Spinal metastasis causes severe neurological deficits, resulting in drastic loss of patients' PS and ADL. However, the effect of spine surgery on PS and ADL is not well known...
October 19, 2016: Clinical Spine Surgery
Nadia Haj Mohammad, Sophia De Rooij, Maarten Hulshof, Jelle Ruurda, Bas Wijnhoven, Frans Erdkamp, Meindert Sosef, Suzanne Gisbertz, Mark van Berge Henegouwen, Mirjam Sprangers, Hanneke van Laarhoven
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is a treatment with curative intent for resectable esophageal cancer. The aim of this study was to measure activities of daily living (ADL) and quality of life (QoL), and to examine correlates of changes in ADL and QoL. METHODS: A prospective study was performed with three time points (baseline, 1 week after the end of nCRT, 3-months post-surgery) together with a cross-sectional post-treatment study...
October 20, 2016: Journal of Surgical Oncology
Teresa Liu-Ambrose, John R Best, Jennifer C Davis, Janice J Eng, Philip E Lee, Claudia Jacova, Lara A Boyd, Penelope M Brasher, Michelle Munkacsy, Winnie Cheung, Ging-Yuek R Hsiung
OBJECTIVE: To assess the efficacy of a progressive aerobic exercise training program on cognitive and everyday function among adults with mild subcortical ischemic vascular cognitive impairment (SIVCI). METHODS: This was a proof-of-concept single-blind randomized controlled trial comparing a 6-month, thrice-weekly, progressive aerobic exercise training program (AT) with usual care plus education on cognitive and everyday function with a follow-up assessment 6 months after the formal cessation of aerobic exercise training...
October 19, 2016: Neurology
Anne van der Vorst, G A Rixt Zijlstra, Nico De Witte, Daan Duppen, Andreas E Stuck, Gertrudis I J M Kempen, Jos M G A Schols
BACKGROUND: Most older people wish to age in place, for which functional status or being able to perform activities of daily living (ADLs) is an important precondition. However, along with the substantial growth of the (oldest) old, the number of people who develop limitations in ADLs or have functional decline dramatically increases in this part of the population. Therefore, it is important to gain insight into factors that can contribute to developing intervention strategies at older ages...
2016: PloS One
Jiyoung Lyu, Hae-Young Kim
OBJECTIVE: This study investigated gender-specific incidence and predictors of cognitive impairment among community-dwelling older adults in South Korea. METHODS: Using data from the 2006 and 2012 Korean Longitudinal Study of Ageing (KLoSA), 925 females and 834 males aged 65 and over without cognitive impairment at 2006 were analyzed separately. Cognitive impairment was measured based on the Korean version of the Mini-Mental State Exam (K-MMSE) normative score. Generalized Estimating Equations (GEE) was conducted to examine the predictors of cognitive impairment at 6-year follow up...
September 2016: Psychiatry Investigation
Lauren E Griffith, Parminder Raina, Mélanie Levasseur, Nazmul Sohel, Hélène Payette, Holly Tuokko, Edwin van den Heuvel, Andrew Wister, Anne Gilsing, Christopher Patterson
BACKGROUND: We examine the population impact on functional disability and social participation of physical and mental chronic conditions individually and in combination. METHODS: Cross-sectional, population-based data from community-dwelling people aged 45 years and over living in the 10 Canadian provinces in 2008-2009 were used to estimate the population attributable risk (PAR) for functional disability in basic (ADL) and instrumental (IADL) activities of daily living and social participation restrictions for individual and combinations of chronic conditions, stratified by age and gender, after adjusting for confounding variables...
October 17, 2016: Journal of Epidemiology and Community Health
M Iki, Y Fujita, J Tamaki, K Kouda, A Yura, Y Sato, J S Moon, A Harano, K Hazaki, E Kajita, M Hamada, K Arai, K Tomioka, N Okamoto, N Kurumatani
: Frail elderly individuals have elevated risks of both fracture and mortality. We found that incident fractures were associated with an increased risk of death even after adjusting for pre-fracture frailty status as represented by physical performance tests and laboratory tests for common geriatric diseases in community-dwelling elderly Japanese men. INTRODUCTION: While fractures reportedly increase the risk of mortality, frailty may complicate this association, generating a false-positive result...
October 18, 2016: Osteoporosis International
Roderick Wondergem, Martijn F Pisters, Eveline J Wouters, Nick Olthof, Rob A de Bie, Johanna M A Visser-Meily, Cindy Veenhof
BACKGROUND: Stroke is not only an acute disease, but for the majority of patients, it also becomes a chronic condition. There is a major concern about the long-term follow-up with respect to activities of daily living (ADL) in stroke survivors. Some patients seem to be at risk for decline after a first-ever stroke. The purpose of this study was to determine the course of ADL from 3 months after the first-ever stroke and onward and identify factors associated with decline in ADL. METHODS: A systematic literature search of 3 electronic databases through June 2015 was conducted...
October 18, 2016: Cerebrovascular Diseases
Lukshe Kanagaratnam, Moustapha Dramé, Jean-Luc Novella, Thierry Trenque, Clarisse Joachim, Pierre Nazeyrollas, Damien Jolly, Rachid Mahmoudi
OBJECTIVE: To identify risk factors for the occurrence of adverse drug reactions (ADRs) based on geriatric evaluation. DESIGN: Longitudinal prospective study from May 2010 to November 2011. SETTING: Dedicated acute geriatric care unit specializing in the management of patients with dementia syndrome (Alzheimer disease or related syndromes) at the University Hospital of Reims, France. PARTICIPANTS: Older patients with dementia syndrome (Alzheimer disease or related syndromes)...
September 1, 2016: American Journal of Geriatric Psychiatry
Li-Jung Chen, Andrew Steptoe, Po-Wen Ku
BACKGROUND: Obesity has been associated with increased physical limitations among older adults, although few studies have adjusted for important covariates. There is limited information about the relationship between apolipoprotein E (APOE) polymorphisms and physical limitations, and the findings have been inconsistent. PURPOSE: This study examined the longitudinal associations of obesity and APOE ε4 with difficulties in activities of daily living (ADLs) over a 6-year follow-up period controlling for multiple covariates...
October 13, 2016: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
Hanneke Ac van Helvoort, Laura M Willems, Pn Richard Dekhuijzen, Hieronymus Wh van Hees, Yvonne F Heijdra
In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL and to study its consequences on dyspnoea, physical activity and health status in early-stage COPD compared with healthy controls. In this cross-sectional study, 39 early-stage COPD patients (mean FEV1 88±s...
October 13, 2016: NPJ Primary Care Respiratory Medicine
Nienke Nakken, Daisy J A Janssen, Esther H A van den Bogaart, Monique van Vliet, Geeuwke J de Vries, Gerben P Bootsma, Michiel H M Gronenschild, Jeannet M L Delbressine, Jean W M Muris, Emiel F M Wouters, Martijn A Spruit
BACKGROUND AND OBJECTIVE: Loved ones (proxies) of patients with COPD are confronted with the patients' limitations in activities of daily living (ADLs). However, it remains unknown whether proxies are able to correctly estimate the problematic ADLs of the patient. Therefore, we aimed to investigate the level of agreement between patient-reported and proxy-reported problematic ADLs of the patient. METHODS: Stable outpatients with moderate to very severe COPD (n = 194) and their resident proxies (n = 194) were included in this cross-sectional study...
October 12, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Kim Robin Spekreijse, Guus Maarten Vermeulen, Thybout M Moojen, Harm P Slijper, Steven E R Hovius, Ruud W Selles, Reinier Feitz
BACKGROUND: Hypermobility of the first carpometacarpal joint is mostly surgically treated with a volar approached stabilization by Eaton, but recent studies indicate the importance of the dorsoradial and intermetacarpal ligaments (DRL and IML) for carpometacarpal joint stability. The aim of this study was to compare a dorsal and volar technique for primary carpometacarpal hypermobility regarding pain and functional outcome. METHODS: Patients with non-degenerative, painful carpometacarpal hypermobility were included and were randomly assigned to either the volar technique using the FCR, or a dorsal technique using the ECRL...
2016: European Journal of Plastic Surgery
Lianghua Chen, Junqi Chen, Qiyuan Peng, Jingjie Chen, Yucong Zou, Gang Liu
OBJECTIVE: This study aims to evaluate the effect of sling exercise training (SET) on balance in patients with stroke. METHODS: PubMed, Cochrane Library, Ovid LWW, CBM, CNKI, WanFang, and VIP databases were searched for randomized controlled trials of the effect of SET on balance in patients with stroke. The study design and participants were subjected to metrological analysis. Berg balance Scale (BBS), Barthel index score (BI), and Fugl-Meyer Assessment (FMA) were used as independent parameters for evaluating balance function, activities of daily living(ADL) and motor function after stroke respectively, and were subjected to meta-analysis by RevMan5...
2016: PloS One
K Rosqvist, P Hagell, P Odin, H Ekström, S Iwarsson, M H Nilsson
OBJECTIVES: To identify factors associated with life satisfaction (LS) in people with Parkinson's disease (PD), including a specific focus on those with late-stage PD. MATERIAL AND METHODS: The study included 251 persons with PD (median age 70 years; PD duration 8 years). Analyses involved the total sample and a subsample with late-stage PD, that is Hoehn and Yahr stages IV and V (n=62). LS was assessed with item 1 of the Life Satisfaction Questionnaire (LiSat-11)...
October 10, 2016: Acta Neurologica Scandinavica
Tsair-Wei Chien, Weir-Sen Lin
BACKGROUND: Computer adaptive testing (CAT) of the activities of daily living (ADL) functions is required (i) to reveal the advantages of using an efficient and accurate estimation method, (ii) to determine the cutpoint for classifying ADL strata in patients with stroke, and (iii) to evaluate the feasibility of online CAT used in clinical settings for smartphones. METHODS: Normally standardized distributions of ADL measurements were simulated using item parameters from published papers...
October 10, 2016: BMC Medical Informatics and Decision Making
Oanh Tran Thi Hoang, Pornchai Jullamate, Naiyana Piphatvanitcha, Edwin Rosenberg
AIMS AND OBJECTIVES: To investigate the relationship between age, gender, history of falls, balance and gait status, general health perception, activities of daily living and depression to fear of falling in community-dwelling older people in Danang, Vietnam. BACKGROUND: Fear of falling is a common and consequential psychosocial problem for older people and can lead to decreased quality of life. There is only limited research on fear of falling in Vietnam. DESIGN: This is a cross-sectional descriptive study...
October 9, 2016: Journal of Clinical Nursing
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