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Geriatric medicine

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https://www.readbyqxmd.com/read/28917331/-polypharmacy-and-geriatric-psychiatry
#1
Abdelkrim Hamzaoui, André Joulié, Yahya El Dachri
The ageing of the population is synonymous with multiple pathologies and polypharmacy, which increases risk factors. François-Tosquelles general hospital carried out a study into the administering of medicines within the ageing population in psychiatry and drew up an assessment of professional practices with regard to polypharmacy in geriatric psychiatry.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28917330/-oral-administration-of-medicines-in-elderly-patients-and-adaptation-of-galenic-forms
#2
Éric Pautas, Lasamy Bui, Alexandra Monti, Sébastien Krypciak, Anastasia Obraztsova, Eléna Paillaud
Physiological ageing and pathologies can have an influence on the pharmacology of numerous medicines, leading to serious iatrogenic accidents, polypharmacy and incorrect use of a medicine in elderly people. An observational study carried out in a short-stay geriatric unit focused on the issues surrounding the difficulties the elderly may encounter when taking medicines and the prevalence of the manipulation of galenic forms.
September 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/28913934/the-incidence-of-sarcopenia-among-hospitalized-older-patients-results-from-the-glisten-study
#3
Anna Maria Martone, Lara Bianchi, Pasquale Abete, Giuseppe Bellelli, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Emanuele Marzetti, Maria Rosaria Rizzo, Andrea Rossi, Stefano Volpato, Francesco Landi
BACKGROUND: New evidence is emerging on the importance of lean body mass during periods of illness and recovery. The preservation of lean body mass during such periods of intense stress impacts both patient and treatment outcomes. However, data concerning the incidence of sarcopenia among older people during hospitalization are scarce. The objective of this study was to evaluate the development of sarcopenia in a sample of hospitalized older subjects. METHODS: We used data of 394 participants from the multicentre Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia-Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards (Internal Medicine and Geriatrics) of University Hospitals across Italy...
September 14, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28898146/book-reviews-ultrasound-edited-by-leslie-m-scoutt-ulrike-m-hamper-teresita-l-angtuaco-oxford-university-press-2017-price-%C3%A2-112-50-pp-696-isbn-978-0-19-998810-5-geriatric-rehabilitation-from-bedside-to-curbside-k-rao-poduri-crc-press-2017-price-%C3%A2-140-pp-678
#4
https://www.readbyqxmd.com/read/28890328/are-phase-i-trials-safe-for-older-patients
#5
REVIEW
Capucine Baldini, Olivia Le Saux, Carole Helissey, Sandrine Aspeslagh, Eduardo Castanon, Andreea Varga, Anas Gazzah, Rastio Bahleda, Olivier Mir, Christophe Massard, Jean-Charles Soria, Antoine Hollebecque
Phase I clinical trials in oncology primarily aim to assess the toxicity profile of new drugs and determine recommended phase II doses (RP2D). Since the cancer rate increases with age and our population is continually aging, RP2D must necessarily be assessed in older patients. Few clinical studies include older patients, however, and particularly few Phase I trials. We reviewed published data on the safety and efficacy of Phase I trials in older patients. The majority of studies included primarily young, fit patients, with age thresholds varying widely from 65 to 80years...
September 7, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28884807/co-creation-by-the-abim-geriatric-medicine-board-and-the-ags-helping-move-geriatrics-forward
#6
Bruce Leff, Nancy E Lundjeberg, Sharon A Brangman, Joyce Dubow, Sharon Levine, Melissa Morgan-Gouveia, Jeffrey Schlaudecker, Lorna Lynn, Furman S McDonald
The American board of internal medicine (ABIM) establishes standards for physicians. The American geriatrics society (AGS) is a not-for-profit membership organization of nearly 6,000 health professionals devoted to improving the health, independence, and quality of life of all older people. Beginning in 2013, ABIM redesigned its governance structure, including the role of the specialty boards. Specialty boards are charged with responsibilities for oversight in four main areas: (1) the assessments used in initial certification and maintenance of certification (MOC); (2) medical knowledge self-assessment and practice assessment in the specialty; (3) building relationships with relevant professional societies and other organizational stakeholders; and (4) issues related to training requirements for initial certification eligibility within the specialty...
September 7, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28883032/screening-for-atrial-fibrillation-in-hospitalised-geriatric-patients
#7
Rene Tavernier, Michael Wolf, Vikas Kataria, Tom Phlips, Ruben Huys, Philippe Taghji, Ruan Louw, Raf Van Hoeyweghen, Yves Vandekerckhove, Sébastien Knecht, Mattias Duytschaever
OBJECTIVES: To assess whether daily short-term rhythm strip recordings on top of routine clinical care could increase the atrial fibrillation (AF) detection rate in the hospitalised elderly. METHODS: A hand-held device storing a bipolar ECG during 1 min was used for daily rhythm recording in hospitalised elderly patients. RESULTS: During 2 months, all patients admitted to the Department of Geriatric Medicine were screened (n=327). Five patients refused to participate in the study and 70 patients were unable to hold the device due to severe mental (n=46) or motor impairment (n=24)...
September 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28874007/new-horizons-in-comprehensive-geriatric-assessment
#8
S G Parker, A McLeod, P McCue, K Phelps, M Bardsley, H C Roberts, S P Conroy
In this article, we discuss the emergence of new models for delivery of comprehensive geriatric assessment (CGA) in the acute hospital setting. CGA is the core technology of Geriatric Medicine and for hospital inpatients it improves key outcomes such as survival, time spent at home and institutionalisation. Traditionally It is delivered by specialised multidisciplinary teams, often in dedicated wards, but in recent years has begun to be taken up and developed quite early in the admission process (at the 'front door'), across traditional ward boundaries and in specialty settings such as surgical and pre-operative care, and oncology...
September 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28873217/geriatrics-literature-2016-year-in-review
#9
Kaitlin Willham, Kenneth Covinsky, Eric Widera
We present 10 of the most effective articles from 2016 in geriatric medicine. They address wide-ranging topics including the use of antipsychotics for delirium in palliative care, fall prevention and mobility interventions, efficacy and potential risks of testosterone, cranberry capsules and their effect on bacteriuria and pyuria, beta-blockers after acute myocardial infarction in a nursing home population, the effect of a healthy lifestyle on disability, a goals-of-care intervention in individuals with advanced dementia, the benefits of regional anesthesia in hip repair, and mindfulness in chronic pain management...
September 5, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28871317/-drug-therapy-safety-at-the-transition-from-hospital-to-community-medicine
#10
M Hahn, S C Roll, J Klein
OBJECTIVE: We evaluated the qualitative and quantitative changes of medications during the stay on a geriatric-psychiatric ward where the medication was optimized by a clinical pharmacist, and after discharge. The goal of the study was to analyze the continuity of the medication at the transfer from hospital to ambulatory care. METHODS: We interviewed 41 patients on the phone about their drug regimen 4 and 12 weeks after discharge. Medications were compared to their discharge medication...
September 4, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28869295/the-clinical-potential-of-senolytic-drugs
#11
James L Kirkland, Tamara Tchkonia, Yi Zhu, Laura J Niedernhofer, Paul D Robbins
Senolytic drugs are agents that selectively induce apoptosis of senescent cells. These cells accumulate in many tissues with aging and at sites of pathology in multiple chronic diseases. In studies in animals, targeting senescent cells using genetic or pharmacological approaches delays, prevents, or alleviates multiple age-related phenotypes, chronic diseases, geriatric syndromes, and loss of physiological resilience. Among the chronic conditions successfully treated by depleting senescent cells in preclinical studies are frailty, cardiac dysfunction, vascular hyporeactivity and calcification, diabetes mellitus, liver steatosis, osteoporosis, vertebral disk degeneration, pulmonary fibrosis, and radiation-induced damage...
September 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28866355/use-of-the-spanish-version-of-the-rapid-geriatric-assessment-in%C3%A2-mexican-patients-in-long-term-care
#12
Jorge Alberto Mena-Madrazo, Beatriz E Mariscal-Martinez, Mariana Leon-Quintero, Stephanie M Lupercio Macias
We report our experience with the use of a Spanish version of the rapid geriatric assessment of 30 patients in 2 long-term care institutions in Mexico City by a group of healthcare students without prior experience in geriatric medicine. The Spanish version of the rapid geriatric assessment is a very easy tool to administer that can provide overall good results for identifying frailty, sarcopenia, anorexia, weight loss, and cognitive impairment.
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28856791/predictors-on-admission-of-functional-decline-among-older-patients-hospitalised-for-acute-care-a-prospective-observational-study
#13
David Basic, Danielle Ní Chróinín, David Conforti, Chris Shanley
OBJECTIVE: We sought to investigate the incidence of, and factors associated with, in-hospital functional decline among older acute hospital patients. METHODS: We conducted a prospective observational study of consecutive patients admitted under geriatric medicine over 5 years. The primary outcome measure was functional decline between admission and discharge, representing deterioration in any of the following: Modified Barthel Index (MBI), independence in Timed Up and Go test or walking, and/or need for walking aid...
August 30, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28856665/discharge-plans-for-geriatric-inpatients-with-delirium-a-plan-to-stop-antipsychotics
#14
Kim G Johnson, Adedayo Fashoyin, Ramiro Madden-Fuentes, Andrew J Muzyk, Jane P Gagliardi, Mamata Yanamadala
BACKGROUND: Studies show inpatient geriatric patients with reversible conditions like delirium may continue on antipsychotic medications without clear indications after hospital discharge. We conducted this study to determine how often geriatric patients were discharged on a newly started antipsychotic during admission with a plan for discontinuation of the antipsychotic documented in the discharge summary. DESIGN: We conducted retrospective chart review identifying geriatric inpatients in our health system started on a new antipsychotic during admission...
August 30, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28846131/development-and-validation-of-a-geriatrics-knowledge-test-to-evaluate-geriatrics-fellowship-programs
#15
Alia T Tuqan, Ming Lee, Nancy T Weintraub, David B Reuben
BACKGROUND/OBJECTIVES: Although the Accreditation Council for Graduate Medical Education requires that geriatrics fellowship programs be evaluated, evaluation is challenging because of lack of appropriate instruments. The purpose of this study was to develop and validate a geriatrics knowledge test appropriate for evaluation of geriatrics fellowship programs. DESIGN: Initial and replication cross-sectional validation studies. SETTING: Academic medical center...
August 28, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28843457/development-and-validation-of-a-family-meeting-assessment-tool-fmat
#16
Yuya Hagiwara, Jennifer Healy, Shuko Lee, Jeanette Ross, Dixie Fischer, Sandra Sanchez-Reilly
CONTEXT: A cornerstone procedure in Palliative Medicine is to perform family meetings. Learning how to lead a family meeting is an important skill for physicians and others who care for patients with serious illnesses and their families. There is limited evidence on how to assess best practice behaviors during end of life family meetings. OBJECTIVES: Our aim was to develop and validate an observational tool to assess trainees' ability to lead a simulated end-of-life family meeting...
August 23, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28834845/primary-care-residents-in-teaching-health-centers-their-intentions-to-practice-in-underserved-settings-after-residency-training
#17
Zohray Talib, Mariellen Malloy Jewers, Julia H Strasser, David K Popiel, Debora Goetz Goldberg, Candice Chen, Hayden Kepley, Fitzhugh Mullan, Marsha Regenstein
PURPOSE: To describe the residents who chose to train in teaching health centers (THCs), which are community-based ambulatory patient care sites that sponsor primary care residencies, and their intentions to practice in underserved settings. METHOD: The authors surveyed all THC residents training in academic years 2013-2014, 2014-2015, and 2015-2016, comparing their demographic characteristics with data available for residents nationally, and examined THC residents' intentions to practice in underserved settings using logistic regression analysis...
August 22, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28802465/integrative-medicine-for-geriatric-and-palliative-care
#18
REVIEW
Mikhail Kogan, Stephanie Cheng, Seema Rao, Sharon DeMocker, Mariatu Koroma Nelson
More than 80% of people in the United States who are older than 65 years have 1 or more chronic medical problems, and 50% have 2 or more. The cost of care for the elderly is at least 3 to 4 times that of younger populations and is rapidly growing, mostly because of a lack of preventive approaches and overly medicalized and fragmented care. This article summarizes the most up-to-date evidence for specific integrative modalities for common geriatric conditions, including falls, frailty, osteoporosis, and end-of-life palliative care...
September 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28799157/-social-medicine-and-interfaces-in-sectoral-health-care-provision
#19
Hans Gerber, Christian Alex, Michael Penz, Michael Röder, Gert von Mittelstaedt
In addition to the consideration of individual medicine, social medicine focuses on the social references of health and sickness. In this context, it reflects the structures of the entire health care system, its functions and its functional deficits. It deals with the specific interaction between medicine and society and functions such as a link to the classical social sciences (1). Of particular interest in this context are the interfaces to sectoral health care provision. The working group "Nursing Care" of the Department "Practical Social Medicine and Rehabilitation" of the German Society for Social Medicine and Prevention examines the fundamental interfaces in our sectoral health care system from the perspective of social medicine in their current functions and perspectives, particularly in view of the future demographic challenges to be faced...
August 10, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28797376/advance-care-planning-in-the-outpatient-geriatric-medicine-setting
#20
REVIEW
Bryan David Struck, Elizabeth Aubrey Brown, Stefani Madison
This article describes how to perform advance care planning in the outpatient geriatric medicine setting. The article defines advance care planning and discusses components of advance care planning, such as advance directives, do-not-resuscitate orders, and Physician Orders for Life-Sustaining Treatment. The article describes how to document advance care planning discussions in the clinic and bill Medicare and ways for clinicians to improve their skill at leading these conversations.
September 2017: Primary Care
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