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Geriatric medicine

Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Lukas K Schoenenberger, Steffen Bayer, John P Ansah, David B Matchar, Rajagopal L Mohanavalli, Sean Sw Lam, Marcus Eh Ong
OBJECTIVES: Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care...
2016: SAGE Open Medicine
Francesco Spannella, Federico Giulietti, Silvia Buscarini, Piero Giordano, Maddalena Ricci, Emma Espinosa, Riccardo Sarzani
OBJECTIVE: Age is considered one of the main risk factors for cardiovascular (CV) disease and aging seems to play a central role in the onset and progression of atherosclerosis. AIM: to compare the prevalence of carotid plaque in a very elderly population without history of peripheral arterial disease (PAD) and major adverse cardiovascular events (MACE), with the prevalence in a population of hypertensive adults. DESIGN AND METHOD: We studied 179 patients: 69 hospitalized very elderly (mean age: 88...
September 2016: Journal of Hypertension
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Ronald J Maggiore, Kathryn E Callahan, Janet A Tooze, Ira R Parker, Tina Hsu, Heidi D Klepin
The number of older adults with cancer is growing, necessitating more collaborative training in both geriatric principles and cancer care. We administered a web-based survey to U.S. geriatrics program directors (PDs) addressing cancer-specific training and perspectives on optimal training content and roles for geriatricians in cancer care. Of 140 PDs contacted, 67 (48%) responded. Topics considered very important in training included cancer screening (79%) and cancer-related pain management (70%). Respondents strongly agreed that some of the geriatrician's roles in cancer care included assessing functional status (64%) and assessing physical/cognitive function for goals of care (64%)...
October 17, 2016: Gerontology & Geriatrics Education
E Chapman, A Eastman, A Gilmore-Bykovskyi, B Vogelman, A J Kind
Older adults often face poor outcomes when transitioning from hospital to home. Although physicians play a key role in overseeing transitions, there is a lack of practice-based educational programs that prepare resident physicians to manage care transitions of older adults. An educational intervention to provide residents with real-life transitional care practice was therefore developed-Resident-coordinated Transitional Care (RC-TraC). RC-TraC adapted the evidence-based Coordinated-Transitional Care (C-TraC) nurse role for residents, providing opportunities to follow patients during the peri-hospital period without additional costs to the residency program...
October 17, 2016: Gerontology & Geriatrics Education
Pavel Weber, Hana Meluzínová, Dana Prudius, Katarína Bielaková
Polypharmacy is common in the elderly, especially in the late age (over 75 years). Usually it is closely related to the geriatric multi-morbidity. The authors highlight the medication used in the anticipated positive and potential negative potential. While physicians often must make difficult trade-offs between the guidelines on one hand and complicated multi-morbidity, on the other hand, while trying to avoid polypharmacy ( 5 drugs), especially excessive polypharmacy ( 10 drugs). Multimorbid elderly patients who are treated in accordance with guidelines typically use large amounts of medicaments...
2016: Vnitr̆ní Lékar̆ství
Abdelouahab Bellou, Simon P Conroy, Colin A Graham
No abstract text is available yet for this article.
August 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Chun-Fang Chiu, Miaw-I Lin, I Lee, Shiow-Rong Jeang, Yan-Choiu Ku
BACKGROUND: Unplanned readmissions increase healthcare utilization rates and healthcare costs. The Taiwan Healthcare Indicator Series regards the rate of hospital readmission as an important indicator of inpatient-care quality. The elderly face a higher risk of unplanned readmission due to elderly-specific health and disease characteristics such as deteriorating body functions and the relatively high incidence of complications after the treatment of acute diseases. PURPOSE: To explore the factors that relate to the unplanned readmission of elderly within 90 days of discharge at a geriatric medical center...
October 2016: Hu Li za Zhi the Journal of Nursing
Kim Brøsen, Stig Ejdrup Andersen, Jeanett Borregaard, Hanne Rolighed Christensen, Palle Mark Christensen, Kim Peder Dalhoff, Per Damkier, Jesper Hallas, Jens Heisterberg, Niels Jessen, Gesche Jürgens, Jens Peter Konnerup Kampmann, Britt Elmedal Laursen, Torben Laursen, Lars Peter Nielsen, Birgitte Klindt Poulsen, Henrik Enghusen Poulsen, Ljubica Vukelic Andersen, Thomas Senderovitz, Jesper Sonne
The Danish Society of Clinical Pharmacology was founded in 1976, and mainly thanks to the persistent efforts of the Society, clinical pharmacology became an independent medical speciality in Denmark in 1996. Since then, clinical pharmacology has gone from strength to strength. In the Danish health care system, clinical pharmacology has established itself as an indispensible part of the efforts to promote the rational, safe and economic use of drugs. Clinical pharmacologists are active in drug committees in both hospitals and in the primary sector...
September 29, 2016: Basic & Clinical Pharmacology & Toxicology
C Osuafor, C W Fan, M MacMahon, C McGreevy, F McCarthy
There has been no clear consensus on the assessment and treatment of vitamin D deficiency prior to the publication of the National Osteoporosis Society (NOS) Vitamin D Guideline in 2014. The aim of our study was to assess the practice in a medicine for the older person day hospital setting relative to this guideline. A 6-month retrospective analysis of all new patients who attended service from January to July 2013 was carried out. Seventy-six patients were included in the final analysis. Mean age was 83 years...
2016: Irish Medical Journal
Jennifer M Reckrey
No abstract text is available yet for this article.
September 27, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Michael J Annear, Junko Otani, Jing Li
AIM: Dementia prevalence is accelerating internationally commensurate with population aging. Super-aging countries, including Japan, will experience growing prevalence of this life-limiting condition in the coming decades as a result of falling fertility and mortality. The authors developed and verified a Japanese translation of the Dementia Knowledge Assessment Scale (DKAS-J) to address the paucity of reliable and valid Japanese-language measures, and to elucidate current understanding...
September 29, 2016: Geriatrics & Gerontology International
J X Zhang, M Yin, X M Chen, C Li, D W Wu, S F Ding, B F Du, H P Guo, W D Qin, H N Yang, H Wang
Objective: To investigate the predictive value of early lactate area for mortality in elderly patients with septic shock. Methods: From January 2012 to December 2013, a prospective study was conducted in the Department of Critical Care Medicine, Qilu Hospital of Shandong University. A total of 115 septic shock patients with age ≥65 years were included in the study. Serum lactate was measured every 6 hours, the lactate indicators, including early lactate area, APACHE Ⅱ score etc were recorded. Results: The overall 28-day mortality rate was 67...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Kathleen O'Connell, Ronald Maier
PURPOSE OF REVIEW: The benefits of palliative care for critically ill patients are well recognized, yet acceptance into surgical culture is lagging. With the increasing proportion of geriatric trauma patients, integration of palliative medicine within daily intensive care services to facilitate goal-concordant care is imperative. RECENT FINDINGS: Misconceptions of palliative medicine as it applies to trauma patients linger among trauma surgeons and many continue to practice without routine consultation of a palliative care service...
September 21, 2016: Current Opinion in Critical Care
Nick W Bray, Rowan R Smart, Jennifer M Jakobi, Gareth R Jones
Frailty is a clinical geriatric syndrome caused by physiological deficits across multiple systems. These deficits make it challenging to sustain homeostasis required for the demands of everyday life. Exercise is likely the best therapy to reverse frailty status. Literature to date suggests that pre-frail older adults, those with 1-2 deficits on the Cardiovascular Health Study-Frailty Phenotype (CHS-frailty phenotype), should exercise 2-3 times a week, for 45-60 min. Aerobic, resistance, flexibility, and balance training components should be incorporated but resistance and balance activities should be emphasized...
October 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Sanghamitra Pati, Anjali Sharma, Sandipana Pati, Sanjay Zodpey
India is currently undergoing rapid demographic transition along with dramatic upsurge in the number of elderly adults. Creating a cadre of specialized health care professionals in geriatric medicine is clearly vital to address the health care needs of this growing population. We undertook a mapping of the available academic programs in geriatric health in India and examined their content, duration, architecture and student intake. A total of 20 programs were identified in geriatric health thus highlighting a paucity of training options in this field...
September 20, 2016: Gerontology & Geriatrics Education
Francesco Spannella, Federico Giulietti, Silvia Buscarini, Piero Giordano, Maddalena Ricci, Emma Espinosa, Riccardo Sarzani
OBJECTIVE: Age is considered one of the main risk factors for cardiovascular (CV) disease and aging seems to play a central role in the onset and progression of atherosclerosis. AIM: to compare the prevalence of carotid plaque in a very elderly population without history of peripheral arterial disease (PAD) and major adverse cardiovascular events (MACE), with the prevalence in a population of hypertensive adults. DESIGN AND METHOD: We studied 179 patients: 69 hospitalized very elderly (mean age: 88...
September 2016: Journal of Hypertension
Andrew Vanlint, Khai Loon Tam, Solomon Yu, Renuka Visvanathan
OBJECTIVES: An Observed Structured Clinical Examination (OSCE) was integrated into the assessment for senior medical students undertaking a 4.5-week geriatric medicine teaching block at one campus. The feasibility and acceptability of an OSCE were examined. METHODS: Students completed eight questions regarding the OSCE using a 6-point Likert scale and two additional questions, using free text, highlighting the strengths and potential areas for improvement. Changes were made every 6 months over a two-year period in response to student evaluation...
September 19, 2016: Australasian Journal on Ageing
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