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Chronic disease in elderly

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https://www.readbyqxmd.com/read/28429554/is-there-a-practical-role-for-bone-biopsy-in-chronic-kidney-disease
#1
Terrence Diamond, Grahame J Elder
Bone biopsy is currently the only means to accurately assess renal osteodystrophy and responses to therapeutic interventions. With sedation, the technique is relatively painless, and complications are uncommon. Bone biopsy should be considered when the aetiology of symptoms or biochemical abnormalities is in question, and results may lead to changes in therapy. Although it remains prudent to use antiresorptive drugs cautiously in patients with chronic kidney disease (CKD) stages 3a-4 and low bone mineral density, bone biopsy may not be warranted before commencing therapy in these patients...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#2
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28425322/determinants-of-health-related-quality-of-life-among-elderly-evidence-from-chi-linh-town-vietnam
#3
Nguyen Thanh Huong, Le Thi Hai Ha, Truong Quang Tien
As Vietnam confronts with the challenge of an aging population, the importance of quality of life for elderly people becomes apparent. This article aims to assess health-related quality of life (HRQoL) and its correlates for the elderly, using a cross-sectional study design. A total of 1599 adults, aged 60 years and older, were drawn from the 2016 baseline survey of Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS), which incorporated the EQ-5D, to measure HRQoL. Data were analyzed using multivariate linear regression analyses...
April 1, 2017: Asia-Pacific Journal of Public Health
https://www.readbyqxmd.com/read/28423757/a-medication-reminder-mobile-app-does-it-work-for-different-age-ranges
#4
Mina Fallah, Mobin Yasini
Successful medication adherence particularly in elderly with chronic diseases will improve their self-management. Medication reminder systems could be useful to improve this adherence. This study consists of two phases, designing a mobile medical app based on Android platform and then its evaluation. To develop this application, first, the use case scenarios have been hypothesized in partnership with health professionals and patients used to take medications daily. Unified Modeling Language was used to model the use cases...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423084/immune-system-dysfunction-in-the-elderly
#5
Eduardo Fuentes, Manuel Fuentes, Marcelo Alarcón, Iván Palomo
Human aging is characterized by both physical and physiological frailty that profoundly affects the immune system. In this context aging is associated with declines in adaptive and innate immunity established as immunosenescence. Immunosenescence is a new concept that reflects the age-associated restructuring changes of innate and adaptive immune functions. Thus elderly individuals usually present chronic low-level inflammation, higher infection rates and chronic diseases. A study of alterations in the immune system during aging could provide a potentially useful biomarker for the evaluation of immune senescence treatment...
January 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#6
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422270/characteristics-and-incidence-of-chronic-illness-in-community-dwelling-predominantly-male-u-s-veteran-centenarians
#7
Raya Elfadel Kheirbek, Ali Fokar, Nawar Shara, Leakie K Bell-Wilson, Hans J Moore, Edwin Olsen, Marc R Blackman, Maria D Llorente
OBJECTIVES: To assess the incidence of chronic illness and its effect on veteran centenarians. DESIGN: Retrospective longitudinal cohort study. SETTING: United States Veterans Affairs Corporate Data Warehouse (CDW). PARTICIPANTS: Community-dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians). MEASUREMENTS: The Kaplan-Meier method was used to estimate cumulative incidence of chronic conditions according to age group...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28421390/ofatumumab-combined-with-chlorambucil-for-previously-untreated-chronic-lymphocytic-leukemia-a-phase-i-ii-open-label-study-in-japan
#8
Kiyohiko Hatake, Michinori Ogura, Kohichi Takada, Masafumi Taniwaki, Fanghong Zhang, Taizo Fujita, Kiyoshi Ando
Elderly/comorbid patients with chronic lymphocytic leukemia (CLL) require low-toxicity treatments. Internationally, the standard treatment for such patients is chlorambucil and an anti-CD20 therapy; however, chlorambucil is not approved in Japan. The aim of the present study was to evaluate the safety, efficacy and pharmacokinetics of ofatumumab in combination with chlorambucil in Japanese patients with previously untreated CLL who were inappropriate for fludarabine-based therapy. Ten patients were enrolled and treated in this study, all of whom received at least one dose of the study drugs...
April 18, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28420408/sialylation-regulates-myofibroblast-differentiation-of-human-skin-fibroblasts
#9
Norihiko Sasaki, Yoko Itakura, Masashi Toyoda
BACKGROUND: Fibroblasts are key players in maintaining skin homeostasis and in orchestrating physiological tissue repair and skin regeneration. Dysfunctions in fibroblasts that occur with aging and the senescent process lead to the delayed healing observed in elderly people. The molecular mechanisms leading to fibroblast dysfunction during aging and the senescent process have not yet been clarified. Previously, changes in patterns of glycosylation were observed in fibroblasts in aging and the senescent process, but the effect of these changes on the function of fibroblasts has not been well documented...
April 18, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28418359/-a-rare-concurrence-of-polymyalgia-rheumatica-and-aa-amyloidosis
#10
S G Radenska-Lopovok, O N Kotenko, N F Frolova, A I Zagrebneva, E S Stolyarevich, E V Volodina, V I Chervinko, E V Kryukov, M L Zubkin
Polymyalgia rheumatica (PMR) is a rare chronic inflammatory disease. It predominantly affects the elderly. The disease has a slow onset, pain and stiffness in the muscles of the shoulder and pelvic girdle, fever, weight loss, and a high acute-phase inflammatory response. The disease is concurrent with giant cell arteritis in a quarter of cases, which allows some authors to consider them as two different manifestations of the same pathological process. The kidneys are rarely involved. This disease is rarely complicated by AA amyloidosis...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28417937/study-on-the-health-status-and-health-service-utilization-of-the-elderly-of-a-remote-and-poor-village-in-a-mountainous-area-in-jinzhai-anhui
#11
Chaoqun Hu, Wenya Yu, Yipeng Lv, Haiping Chen, Qiangyu Deng, Lulu Zhang
Background: Despite the rapid development of China's economy, a number of poor areas in China continue to exist. The health status of the elderly in the poor areas is a matter of concern. This study aims to explore the status of the elderly in terms of their health status, health service needs, and utilization among rural residents of a remote and poor village in a mountainous area in Jinzhai, Anhui. Furthermore, this study aims to explore the differences between the nation rural area average level and the remote and poor village in the mountainous area in terms of health status and health service utilization...
April 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28417130/iron-isotopic-composition-of-blood-serum-in-anemia-of-chronic-kidney-disease
#12
Yulia Anoshkina, Marta Costas-Rodríguez, Marijn Speeckaert, Wim Van Biesen, Joris Delanghe, Frank Vanhaecke
Chronic kidney disease (CKD) is a general term for disorders that affect the structure and function of the kidneys. Iron deficiency (ID) and anemia occur in the vast majority of CKD patients, most of whom are elderly. However, establishing the cause of anemia in CKD, and therefore making an informed decision concerning the corresponding therapeutic treatment, is still a challenge. High-precision Fe isotopic analysis of blood serum samples of CKD patients with and without ID/anemia was performed via multi-collector inductively coupled plasma-mass spectrometry (MC-ICP-MS) for such a purpose...
April 18, 2017: Metallomics: Integrated Biometal Science
https://www.readbyqxmd.com/read/28416961/predictive-factors-of-methicillin-resistant-staphylococcus-aureus-infection-in-elderly-patients-with-community-onset-pneumonia
#13
Hyeyoung Jwa, Jong Wook Beom, Jong Hoo Lee
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. METHODS: This study was retrospectively conducted in elderly patients aged ≥65 years, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#14
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413497/antibiotic-de-escalation-principle-in-elderly-patients-with-chronic-obstructive-pulmonary-disease-complicated-with-severe-pneumonia
#15
Baohong Xiao, Mei Wang, Xiaoling Hu, Jinfeng Li, Fangfang Wang, Jiaxing Sun
The present study investigated the clinical effect of antibiotic de-escalation therapy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia. According to the parity method of hospitalization number, 86 cases were selected and divided into the observation and control group with 43 cases each. Based on empirical antibiotic application, levofloxacin and cephalosporin antibiotics were used in the control group. After treatment for 3 days, the regimen was adjusted to antibiotics active against Gram-positive (G+) and Gram-negative (G-) bacteria such as the third or fourth generation cephalosporin antibiotics, combined with aminoglycoside, or macrolide antibiotics according to their effects...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28413367/discharge-planning-screening-older-patients-for-multidisciplinary-team-referral
#16
Carolyn Hegarty, Clare Buckley, Rachel Forrest, Bob Marshall
The objective was to determine whether the Elders Risk Assessment Index can predict multi-disciplinary team referral of older patients (≥ 65 years) in Emergency Department same-day discharges. The study identified 1,376 qualifying individuals from a regional New Zealand hospital database. Of these, 12.7 % were referred to the multi-disciplinary team. Univariate and multivariate analyses were used to explore associations between the Index, its components, and other demographic factors with referral. With every unit increase in the Index there was a 9% increase in the odds of being referred...
October 10, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28413015/-what-to-do-before-a-hypervitaminia-b12-in-the-elderly
#17
REVIEW
Abrar-Ahmad Zulfiqar, Xavier Sui Seng, Elise Duhamel, Nadir Kadri, Jean Doucet, Emmanuel Andres
Hypervitanimia B12 is an early marker of serious pathologies. These include solid neoplasms, malignant blood diseases and acute/chronic hepatopathies. Hypervitaminemia B12 in geriatrics is thereby an indicator in the diagnosis and prognosis of these conditions.
March 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28412691/clinical-effect-of-treatment-on-elderly-chronic-obstructive-pulmonary-disease-combined-with-pulmonary-tuberculosis
#18
Xiuwu Liu, Chenling Tang, Huimin Xu
OBJECTIVE: To explore and analyze the clinical therapeutic schedule of elderly chronic obstructive pulmonary disease combined with pulmonary tuberculosis. METHOD: This clinical research analysis chooses the 2000 patients suffered elderly chronic obstructive pulmonary disease combined with pulmonary tuberculosis treated in the hospital during June of 2014 and June of 2015 as the object of observation. These 2000 cases are randomly divided into experimental group and control group...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28410285/comorbidities-in-patients-with-chronic-obstructive-pulmonary-disease-and-pulmonary-rehabilitation-outcomes
#19
Pichapong Tunsupon, Ashima Lal, Mohammed Abo Khamis, M Jeffery Mador
PURPOSE: The objective of this study was to evaluate the impact of comorbidities as potential predictors of the response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). METHODS: The study included 165 patients with COPD with exercise limitations. Comorbidity was classified as cardiac, metabolic, orthopedic, behavioral health problems, or other diseases. Number of comorbidities was grouped as 0, 1, or ≥2. Outcomes were defined as improvement in exercise capacity (maximal exercise capacity, 6-minute walk test, and constant workload cycle exercise duration) and quality of life (Chronic Respiratory Questionnaire)...
April 12, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28409747/the-importance-of-identifying-early-changes-in-cardiac-structure-and-function-for-the-prevention-of-cognitive-impairment-and-dementia
#20
Jodi D Edwards
Multiple cardiac pathologies have been shown to contribute to progressive cognitive decline and dementia in elderly populations, including left ventricular hypertrophy (LVH), a marker of prolonged exposure to hypertension. Although associations between chronic hypertension and cognitive function are thought to be mediated primarily by these end organ effects, there is increasing evidence that early changes in cardiac structure and function, such as LVH, may independently contribute to cognitive decline and impairment...
April 10, 2017: Journal of Alzheimer's Disease: JAD
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