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Geriatric medicine

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https://www.readbyqxmd.com/read/29165543/identification-of-older-adults-with-frailty-in-the-emergency-department-using-a-frailty-index-results-from-a-multinational-study
#1
Audrey-Anne Brousseau, Elsa Dent, Ruth Hubbard, Don Melady, Marcel Émond, Éric Mercier, Andrew P Costa
Objective: frailty is a central concept in geriatric medicine, yet its utility in the Emergency Department (ED) is not well understood nor well utilised. Our objectives were to develop an ED frailty index (FI-ED), using the Rockwood cumulative deficits model and to evaluate its association with adverse outcomes. Method: this was a large multinational prospective cohort study using data from the interRAI Multinational Emergency Department Study. The FI-ED was developed from the Canadian cohort and validated in the multinational cohort...
November 20, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29153536/frailty-in-hospitalized-older-adults-comparing-different-frailty-measures-in-predicting-short-and-long-term-patient-outcomes
#2
Edward Chong, Esther Ho, Jewel Baldevarona-Llego, Mark Chan, Lynn Wu, Laura Tay, Yew Yoong Ding, Wee Shiong Lim
OBJECTIVES: Data for the assessment of frailty in acutely ill hospitalized older adults remains limited. Using the Frailty Index (FI) as "gold standard," we compared (1) the diagnostic performance of 3 frailty measures (FRAIL, Clinical Frailty Scale [CFS], and Tilburg Frailty Indicator [TFI]) in identifying frailty, and (2) their ability to predict negative outcomes at 12 months after enrollment. DESIGN: Prospective cohort study. PARTICIPANTS: We recruited 210 patients (mean age 89...
November 15, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29151307/quality-of-life-and-fall-risk-in-frail-hospitalized-elderly-patients
#3
Zeynel Abidin Öztürk, Sedat Özdemir, İbrahim Halil Türkbeyler, Zeynep Demir
Background/aim: Frailty is a complex, multifactorial, and important geriatric syndrome characterized by decline in physiological reserves and functional deficiency in multiple systems. The aim of the current study is to investigate the prevalence of frailty and to determine the correlation between quality of life (QoL) and falling risk in geriatric hospitalized patients. Materials and methods: A total of 420 patients, aged 65 years and above, were enrolled in the study. All participants were hospitalized at a university hospital in the internal medicine clinics...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29133765/geriatric-anesthesia-related-morbidity-and-mortality-in-china-current-status-and-trend
#4
REVIEW
Yang Liu, Wei Xiao, Ling-Zhong Meng, Tian-Long Wang
OBJECTIVE: The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. DATA SOURCES: Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29132430/hospital-choice-in-germany-from-the-patient-s-perspective-a-cross-sectional-study
#5
Werner de Cruppé, Max Geraedts
BACKGROUND: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision? METHODS: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29129215/frailty-screening-and-interventions-considerations-for-clinical-practice
#6
REVIEW
Jeremy Walston, Brian Buta, Qian-Li Xue
Frailty is recognized as a cornerstone of geriatric medicine. It increases the risk of geriatric syndromes and adverse health outcomes in older and vulnerable populations. Although multiple screening instruments have been developed and validated to improve feasibility in clinical practice, frequent lack of agreement between frailty instruments has slowed broad implementation of these tools. Despite this, interventions to improve frailty-related health outcomes developed to date include exercise, nutrition, multicomponent interventions, and individually tailored geriatric care models...
February 2018: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/29128438/renin-angiotensin-system-blockers-and-statins-are-associated-with-lower-in-hospital-mortality-in-very-elderly-hypertensives
#7
Francesco Spannella, Federico Giulietti, Paolo Balietti, Guido Cocci, Laura Landi, Francesca Elena Lombardi, Elisabetta Borioni, Beatrice Bernardi, Giulia Rosettani, Valentina Bordoni, Riccardo Sarzani
OBJECTIVES: Cardiovascular diseases are mainly related to hypertension and dyslipidemia and increase with aging because of the larger time span for these risk factors to damage arterial blood vessels. The impact of cardiovascular drug therapy on outcomes in the very elderly hospitalized is still not well established. The aim of our study was to evaluate the associations between cardiovascular therapy and in-hospital mortality in very elderly hypertensives. DESIGN: Prospective observational study...
November 8, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29125004/impact-of-the-automated-dose-dispensing-with-medication-review-on-geriatric-primary-care-patients-drug-use-in-finland-a-nationwide-cohort-study-with-matched-controls
#8
Juha Sinnemäki, Marja Airaksinen, Maria Valaste, Leena K Saastamoinen
OBJECTIVE: In an automated dose dispensing (ADD) service, medicines are dispensed in unit-dose bags according to administration times. When the service is initiated, the patient's medication list is reconciled and a prescription review is conducted. The service is expected to reduce drug use. The aim of this national controlled study was to investigate whether the ADD service with medication review reduces drug use among geriatric primary care patients. DESIGN, SETTING AND PATIENTS: This is a nationwide cohort study with matched controls...
November 10, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29124354/parathyroid-thyroid-and-recurrent-laryngeal-nerve-anatomy-in-an-indian-rhinoceros-rhinoceros-unicornis
#9
R Udelsman, S B Citino, M Prasad, P I Donovan, D V Fredholm
INTRODUCTION: The parathyroid gland was first identified in the Indian rhinoceros in 1849 by Sir Richard Owen. We performed a necropsy in an Indian rhinoceros, recapitulating Owen's dissection and display what appear to be the initial identification of the recurrent laryngeal nerve in situ and the anatomy and histology of the largest rhinoceros parathyroid glands yet identified. MATERIALS AND METHODS: Patrick T. Rhino, a 41-year-old Indian rhinoceros was born in 1974...
November 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29121542/risk-factors-for-three-month-mortality-after-discharge-in-a-cohort-of-non-oncologic-hospitalized-elderly-patients-results-from-the-reposi-study
#10
Luca Pasina, Laura Cortesi, Mara Tiraboschi, Alessandro Nobili, Giovanna Lanzo, Mauro Tettamanti, Carlotta Franchi, Pier Mannuccio Mannucci, Silvia Ghidoni, Andrea Assolari, Antonio Brucato
BACKGROUND: Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients...
November 6, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29119129/aging-partners-managing-chronic-illness-together-introducing-the-content-collection
#11
Alexandra C H Nowakowski, J E Sumerau
Prior literature on illness management within intimate relationships demonstrates a variety of benefits from supportive partnership. Indeed, much of the earliest research in this field engaged older adults with and without chronic conditions. However, this pioneering literature gave little consideration to relationships in which multiple partners were coping with chronic illness. By contrast, the majority of published manuscripts presented a "sick partner/well partner" model in which caregiving flowed only in one direction...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29109936/a-study-of-harmful-drug-drug-interactions-due-to-polypharmacy-in-hospitalized-patients-in-goa-medical-college
#12
Akshay Khandeparkar, Padmanabh V Rataboli
Introduction: Concomitant use of multiple drugs is often indicated to manage comorbid conditions and enhance efficacy. Such concomitant use of multiple drugs (five or more drugs) has been defined as "polypharmacy." Polypharmacy has been associated with adverse consequences such as greater healthcare costs, increased risk of adverse drug events, drug-drug interactions (DDIs), medication nonadherence, reduced functional capacity, and multiple geriatric syndromes. This study evaluated number of potential harmful DDIs due to polypharmacy...
October 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/29098654/-sdm-supports-better-application-of-ebm-in-geriatric-patients
#13
Esther M M van de Glind, Marjolein H J van de Pol
Evidence based medicine (EBM) is the integration of the best research evidence, clinical expertise and patient values in the decision making process for patient care. However, elderly people are often excluded from participating in scientific studies and they often have multiple morbidities, which complicates the application of EBM. Shared decision making (SDM), a process where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve appropriate treatment can help to shape EBM for this group of patients...
November 2, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/29094499/emergency-medicine-in-the-extreme-geriatric-era-a-retrospective-analysis-of-patients-aged-in-their-mid-90s-and-older-in-the-emergency-department
#14
Martin Müller, Meret E Ricklin, Stefan Weiler, Aristomenis K Exadaktylos, Spyridon Arampatzis
AIM: In the coming years, older individuals will comprise an increasing share of emergency department (ED) admissions, due to the unprecedented and continuing demographic changes. The primary aim of the present study was to identify causes and risk factors for ED admission and hospitalizations in the oldest old. METHODS: We analyzed data of consecutive patients aged in their mid 90s and older (aged ≥94 years) admitted to the ED department of the University Hospital of Bern, Bern, Switzerland, between 2000 and 2010...
November 2, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29083441/measuring-active-and-healthy-ageing-applying-a-generic-interdisciplinary-assessment-model-incorporating-icf
#15
P Stute, N Bitterlich, J Bousquet, F Meissner, M von Wolff, D Poethig
OBJECTIVES: In this study we compared the chronological and bio-functional age between two German speaking cohorts 30 years apart applying a comprehensive and generic Active and Healthy Aging (AHA) assessment model incorporating ICF. METHODS: Single-centre, cross-sectional, observational, non-interventional, non-randomized trial at an University based women's hospital, division of Gynecological Endocrinology and Reproductive Medicine. All participants followed a standardized, holistic battery of biopsychosocial assessments consisting of bio-functional status (BFS), bio-functional age (BFA) and additional validated psychometric questionnaires...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29081401/inadequate-drug-prescribing-comparison-of-inappropriate-drug-rates-at-the-end-of-a-geriatric-short-stay-service-with-three-prescribing-tools
#16
Jean-Luc Fanon, Sandra Dechavigny, Moustapha Dramé, Lidvine Godaert
To compare the proportion of prescriptions containing at least one inappropriate drug, as identified using three tools for optimizing drug prescriptions in the elderly. Cross-sectional, observational study based on the analysis of prescriptions of patients discharged between 1 September and 31 October 2014 in a short-stay geriatrics unit at the Louis Domergue de Trinité Hospital in Martinique (France). Each prescription was analysed using 3 tools, namely one for general medicine (Vidal © drug dictionary) and two tools specifically designed for geriatrics (the Laroche list of potentially inappropriate medications, and the STOPP-START toolkit)...
October 27, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29075195/falls-and-fall-prevention-in-older-persons-geriatrics-meets-spaceflight
#17
REVIEW
Nandu Goswami
This paper provides a general overview of key physiological consequences of microgravity experienced during spaceflight and of important parallels and connections to the physiology of aging. Microgravity during spaceflight influences cardiovascular function, cerebral autoregulation, musculoskeletal, and sensorimotor system performance. A great deal of research has been carried out to understand these influences and to provide countermeasures to reduce the observed negative consequences of microgravity on physiological function...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29074077/-what-how-and-how-much-should-a-family-and-community-medicine-resident-do-to-become-a-good-specialist
#18
M Rodríguez Rodríguez, M Aparcero Gallardo, M C Amodeo Arahal, P Romero Solís
OBJECTIVE: To determine the ideal volume of activity to be carried out by residents in Family and Community Medicine in order to acquire the competencies of their professional activity. MATERIAL AND METHOD: The consensus opinion of a group of experts in the training of residents in Family and Community Medicine was collected from 152 tutors using an online Delphi-type questionnaire. RESULTS: The overall medians obtained in the different activities that should be developed by residents of Family and Community Medicine were: individual diagnostic/therapeutic interventions: retinography 60, spirometry 40, anticoagulation 45, cryo/electrocoagulation 35, infiltrations 45, tele-dermatology 60, and others 45; women's health: pregnancy 45, gynaecological ultrasound/IUD 41, cytology 32...
October 23, 2017: Semergen
https://www.readbyqxmd.com/read/29038950/firing-a-loaded-gun-during-sleep-in-an-elderly-man-with-a-perfect-storm-of-risk-factors-including-severe-obstructive-sleep-apnea
#19
Francesca Ingravallo, Carlos H Schenck, Ernesto D'Aloja, Monica Puligheddu
PURPOSE: We report a case of firing a loaded gun during sleep in a geriatric patient with undiagnosed major sleep disorders and multiple risk factors for sleep violence. Polysomnographic findings, diagnostic challenges, and forensic implications in this unprecedented geriatric case are discussed. METHODS: A 75-year-old employed man, married for 32 years, presented to a sleep center reporting to having fired a shot in his bedroom during sleep while his wife was away, without memory of hearing the gunshot...
October 16, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29029665/mohs-micrographic-surgery-key-pharmacologic-considerations
#20
Diana Fischer, Patricia Orlando, Laura Shane-McWhorter
OBJECTIVE: To describe Mohs micrographic surgery and evaluate whether direct oral anticoagulants should be withheld in patients with atrial fibrillation (Afib) prior to the procedure and to consider what type of antibiotic prophylaxis should be used. SETTING: A community setting in which an elderly patient is living independently at home. PRACTICE DESCRIPTION: Academic-affiliated internal medicine clinic that cares for adult patients of all ages, including elderly patients living independently in their own home...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
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