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Drug use in the elderly

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https://www.readbyqxmd.com/read/29793176/non-ldl-dyslipidemia-is-prevalent-in-the-young-and-determined-by-lifestyle-factors-and-age-the-lifelines-cohort
#1
Jeroen K de Vries, Jan W Balder, Michelle J Pena, Petra Denig, Andries J Smit
BACKGROUND AND AIMS: Non-LDL dyslipidemia (NLD) confers cardiovascular risk, and prevalence rates appear to be high in elderly populations. Small cohorts have identified several lifestyle, anthropometric, and medical factors associated with NLD. We aimed to assess sex- and age-specific prevalence of NLD in a contemporary population cohort (n = 167 729), and to identify independent determinants of NLD, focusing on lifestyle, anthropometric, and medical factors. METHODS: The prevalence of NLD was assessed per 10-year age intervals in adults without cardiovascular disease not using lipid-modifying drugs from the Dutch LifeLines cohort...
May 21, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29790356/-non-opioid-analgesics
#2
Jitka Fricová
Non-opioid analgesics are commonly used to treat mild and moderate acute and chronic pain. They can be used as monotherapy; however, they have greater efficacy in combination with weak and strong opioids. Unlike opioids, long-term use of non-steroidal anti-inflammatory drugs does not lead to physical dependence. One of the main disadvantages of the NSA is the risk of gastrointestinal side effects, especially bleeding into the digestive tract. This is increased especially in ulcerative disease and in higher doses, but also in the elderly (over 65 years), also with concomitant administration of corticosteroids, anticoagulants or other NSAIDs...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29789047/concerns-for-bleeding-in-the-elderly-with-the-use-of-direct-oral-anticoagulants
#3
Michelle Min, Stephanie Sibicky
Since Food and Drug Administration approval of dabigatran in 2010, direct oral anticoagulants (DOACs) have been alternatives to warfarin for patients who are at risk for cardioembolic complications of nonvalvular atrial fibrillation. Unfortunately, there are limited safety data available on the use of these newer agents in older adults, particularly risks of gastrointestinal, intracranial, and major bleeding (as defined by the International Society on Thrombosis and Haemostasis) in those 75 years of age and older...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29788710/hemiballismus-in-uncontrolled-diabetes-mellitus
#4
Juhaida Jaafar, Razlina Abdul Rahman, Nani Draman, Nor Akma Yunus
Hemiballismus, a subtype of chorea, is a rare movement disorder, and is most commonly found secondary to stroke. Movements are involuntary, violent, coarse, and have a wide amplitude. There is increasing report of hemiballismus occurring in non-ketotic hyperglycemia. Spontaneous improvements or remissions were observed in many patients, and treatment should be directed towards the cause of hemiballismus. There is no randomized control trial to guide clinicians in deciding the best treatment option when managing hemiballismus...
May 2018: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29786762/chronic-conditions-and-multimorbidity-in-a-primary-care-population-a-study-in-the-swiss-sentinel-surveillance-network-sentinella
#5
Markus Gnädinger, Lilli Herzig, Alessandro Ceschi, Dieter Conen, Alfred Staehelin, Marco Zoller, Milo A Puhan
OBJECTIVES: To provide estimates of the prevalence of chronic conditions in Swiss primary care. METHODS: In total, 175 general practitioners (GP) or pediatricians (PED) reporting to the Swiss Sentinel Surveillance Network collected morbidity data. RESULTS: In 26,853 patient contacts, mean (± SD) age was 55.8 ± 21.6 or 6.1 ± 5.7 years (in GPs vs. PEDs, respectively) and 47% were males. In GP patients, median Thurgau Morbidity Index was 2 (IQR 1-3)...
May 21, 2018: International Journal of Public Health
https://www.readbyqxmd.com/read/29785841/effects-of-antipsychotic-drugs-on-neurites-relevant-to-schizophrenia-treatment
#6
REVIEW
Xu-Feng Huang, Xueqin Song
Although antipsychotic drugs are mainly used for treating schizophrenia, they are widely used for treating various psychiatric diseases in adults, the elderly, adolescents and even children. Today, about 1.2% of the worldwide population suffers from psychosis and related disorders, which translates to about 7.5 million subjects potentially targeted by antipsychotic drugs. Neurites project from the cell body of neurons and connect neurons to each other to form neural networks. Deficits in neurite outgrowth and integrity are implicated in psychiatric diseases including schizophrenia...
May 22, 2018: Medicinal Research Reviews
https://www.readbyqxmd.com/read/29780096/-the-status-of-glycemic-control-and-hypoglycemia-in-elderly-patients-visiting-the-outpatient-department-specializing-in-diabetes
#7
Yui Soma, Rie Oka, Sumie Fujii, Naoko Ito, Mitsuhiro Kometani, Shigehiro Karashima, Yoshiyu Takeda, Takashi Yoneda, Akimichi Asano
AIM: The Japan Diabetes Society (JDS)/Japan Geriatrics Society (JGS) Joint Committee reported 'Glycemic Targets for Elderly Patients with Diabetes' in 2016. Based on this recommendation, we aimed to clarify 1) the achievement status of glycemic targets in the elderly and 2) the presence of hypoglycemia in real life among elderly individuals with an HbA1c below the lower limit. SUBJECTS AND METHODS: [Analysis I] In 326 elderly with diabetes ≥65 years of age visiting the outpatient department specializing in diabetes, the proportions of patients with HbA1c values below the lower limit and the use of drugs potentially associated with severe hypoglycemia (e...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29780094/-the-treatment-of-patients-with-elderly-onset-rheumatoid-arthritis-at-niigata-rheumatic-center
#8
Chinatsu Takai, Daisuke Kobayashi, Satoshi Ito, Akira Murasawa, Yoko Wada, Ichiei Narita, Kiyoshi Nakazono
AIM: To investigate the clinical course of patients with elderly-onset rheumatoid arthritis (RA). METHODS: We compared the characteristics, and clinical course of 55 patients who developed RA at over 80 years of age (elderly-onset [EO] group) with 119 patients who developed RA at 40-59 years of age (non-elderly onset [non-EO] group). We also investigated the characteristics and clinical course of 19 patients who developed RA at over 80 and who received biological disease-modifying anti-rheumatic drugs (bDMARDs)...
2018: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#9
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779417/constipation-in-the-elderly-from-northern-sardinia-is-positively-associated-with-depression-malnutrition-and-female-gender
#10
Maria Pina Dore, Giovanni Mario Pes, Stefano Bibbò, Patrizia Tedde, Gabrio Bassotti
OBJECTIVES: Constipation is a common complaint in older adults. The rise in life expectancy may amplify the problem and increase social expenditure. We investigated the major risk factors associated with constipation in a large sample of elderly. METHODS: Outpatients from Northern Sardinia attending a Geriatric Unit between 2001 and 2014 were enrolled. Demographic and anthropometric data, income, education and self-reported bowel function were collected. The presence of constipation was adjusted for cognitive status, assessed by the Mini-Mental State Examination (MMSE) test; single and cumulative illness rating scale (CIRS); current or past symptomatic depression and anxiety measured by the Geriatric Depression Scale (GDS); nutritional status, evaluated using the Mini-Nutritional Assessment (MNA); type and number of different medications used...
May 20, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29778548/risk-factors-of-the-peptic-ulcer-bleeding-in-aging-uremia-patients-under-regular-hemodialysis
#11
Xi-Hsuan Lin, Chung-Chi Lin, Yuan-Jen Wang, Jiing-Chyuan Luo, Shih-Hao Young, Ping-Hsien Chen, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND: Previous studies have shown that uremia patients under hemodialysis (HD) have a significantly higher occurrence of peptic ulcer bleeding (PUB) than healthy controls and that elderly patients remain at high risk of peptic ulcer disease (PUD) and PUB. Here we aimed to identify the risk factors for PUB in aging (≥65-years-old) uremic patients under regular HD. METHODS: Using data from the National Health Insurance Research Database of Taiwan, we compared 18,252 aging regular HD patients and 17,883 age-, gender-, and medication-matched patients without kidney disease (control group)...
May 16, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29776316/a-systematic-review-and-combined-analysis-of-therapeutic-drug-monitoring-studies-for-oral-paliperidone
#12
Georgios Schoretsanitis, Edoardo Spina, Christoph Hiemke, Jose de Leon
This article includes a combined analysis of therapeutic drug monitoring (TDM) studies and a review of the marketer's data on pharmacological mechanisms. Areas covered: An article search led to the inclusion of 21 paliperidone studies in the systematic review plus 2 case reports. Paliperidone clearance was calculated from: 1) steady-state studies using concentration/dose (C/D) ratios, and 2) single-dose studies describing 24-hour area under the curve calculations. The marketed extended-release formulation has 28% bioavailability...
May 18, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29765246/efficacy-of-opioids-versus-placebo-in-chronic-pain-a-systematic-review-and-meta-analysis-of-enriched-enrollment-randomized-withdrawal-trials
#13
Diana S Meske, Oluwadolapo D Lawal, Harrison Elder, Valerie Langberg, Florence Paillard, Nathaniel Katz
Introduction: Opioids have been used for millennia for the treatment of pain. However, the long-term efficacy of opioids to treat chronic non-cancer pain continues to be debated. To evaluate opioids' efficacy in chronic non-cancer pain, we performed a meta-analysis of published clinical trials for μ-opioid receptor agonists performed for US Food and Drug Administration approval. Methods: MEDLINE and Cochrane trial register were searched for enriched enrollment randomized withdrawal studies (before June 2016)...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29761371/tolerability-and-efficacy-of-deferasirox-in-patients-with-transfusional-iron-overload-results-from-a-german-2-year-non-interventional-study
#14
Florian Nolte, Holger Nückel, Burkhard Schmidt, Thomas Geer, Oleg Rubanov, Holger Hebart, Andrea Jarisch, Stefan Albrecht, Christiane Johr, Christiane Schumann, Wolf-Karsten Hofmann
BACKGROUND: Iron overload (IOL) due to repetitive transfusions of packed red blood cells (pRBC) has a major impact on morbidity and mortality in patients with inherited bone marrow failure syndromes and hemoglobinopathies such as thalassemia and sickle cell disease. However, whether IOL influences the outcome of elderly patients with myeloid malignancies is not yet clear. Moreover, clinical trials have reported high drop-out rates during treatment with the oral iron chelator deferasirox (DFX)...
May 14, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29760940/analyses-of-non-benzodiazepine-induced-adverse-events-and-prognosis-in-elderly-patients-based-on-the-japanese-adverse-drug-event-report-database
#15
Yoshihiro Noguchi, Anri Ueno, Hayato Katsuno, Manami Otsubo, Aki Yoshida, Yuta Kanematsu, Ikuto Sugita, Tomoya Tachi, Teruo Tsuchiya, Hitomi Teramachi
Background: The contents of the guidelines for the use of non-benzodiazepines (Z-drugs) differ slightly between THE JAPANESE SOCIETY OF SLEEP RESEARCH and THE JAPAN GERIATRIC SOCIETY, and the recommended directions are conflicting. Therefore, we analyzed the use of the Japanese Adverse Drug Event Report database (JADER) for identifying adverse events (AEs) caused by Z-drugs and clarifying their occurrence trend and prognosis. Methods: The signal value for comparison was calculated by using the proportional reporting ratio (PRR) and chi-squared test (χ2 ) results of data of elderly and non-elderly patients...
2018: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/29759150/comprehensive-characterization-of-circulating-and-bone-marrow-derived-multiple-myeloma-cells-at-minimal-residual-disease
#16
REVIEW
Johannes M Waldschmidt, Praveen Anand, Birgit Knoechel, Jens G Lohr
The presence or absence of minimal residual disease (MRD) in patients with multiple myeloma (MM) has emerged as a useful marker to determine the depth of remission. MRD negativity as an endpoint has been shown to be associated with improved progression-free survival in many studies. MRD detection is therefore part of numerous clinical trial protocols for MM. At the present time, two methodologies are most widely accepted for MRD detection: (1) multicolor flow cytometry and (2) next-generation sequencing-based clonotype detection...
January 2018: Seminars in Hematology
https://www.readbyqxmd.com/read/29755695/hypertension-in-malignancy-an-underappreciated-problem
#17
REVIEW
Jolanta Małyszko, Maciej Małyszko, Leszek Kozlowski, Klaudia Kozlowska, Jacek Małyszko
Hypertension is one of the most common comorbidities in cancer patients with malignancy, in particular, in the elderly. On the other hand, hypertension is a long-term consequence of antineoplastic treatment, including both chemotherapy and targeted agents. Several chemotherapeutics and targeted drugs may be responsible for development or worsening of the hypertension. The most common side effect of anti-VEGF (vascular endothelial growth factor) treatment is hypertension. However, pathogenesis of hypertension in patients receiving this therapy appears to be associated with multiple pathways and is not yet fully understood...
April 17, 2018: Oncotarget
https://www.readbyqxmd.com/read/29754512/-stroke-prevention-in-the-elderly-effectiveness-and-safety-of-edoxaban-in-elderly-patients-according-to-the-results-of-the-engage-af-study
#18
László Márk
Atrial fibrillation is the most common clinically relevant arrhythmia frequently causing systemic thromboembolic events. Traditionally vitamin K antagonists had been used for decades to prevent these events. The emerging of the new direct anticoagulants has revolutionized this treatment and a gradual growth and extensive spread of usage is expected. The latest one approved in Hungary, edoxaban, is a factor Xa inhibitor. Once-daily administration and favourable safety profile are major benefits of this drug...
May 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29752625/polypharmacy-among-headache-patients-a-cross-sectional-study
#19
Anna Ferrari, Carlo Baraldi, Manuela Licata, Cecilia Rustichelli
BACKGROUND: Polypharmacy can appropriately treat multiple chronic conditions, but it can also increase potential harm. Polypharmacy information for primary headaches is minimal, despite drugs being the main tools to manage headaches. OBJECTIVE: The aim was to evaluate the prevalence, characteristics and risk factors of polypharmacy in patients with primary headaches and examine whether these variables differ between episodic and chronic headache patients. METHODS: We analysed polypharmacy (simultaneous use of five or more medications), medication type, comorbidity, and risk factors in 300 patients (mean age 42...
May 11, 2018: CNS Drugs
https://www.readbyqxmd.com/read/29751644/protective-effects-of-selected-botanical-agents-on-bone
#20
REVIEW
James Jam Jolly, Kok-Yong Chin, Ekram Alias, Kien Hui Chua, Ima Nirwana Soelaiman
Osteoporosis is a serious health problem affecting more than 200 million elderly people worldwide. The early symptoms of this disease are hardly detectable. It causes progressive bone loss, which ultimately renders the patients susceptible to fractures. Osteoporosis must be prevented because the associated fragility fractures result in high morbidity, mortality, and healthcare costs. Many plants used in herbal medicine contain bioactive compounds possessing skeletal protective effects. This paper explores the anti-osteoporotic properties of selected herbal plants, including their actions on osteoblasts (bone forming cells), osteoclasts (bone resorbing cells), and bone remodelling...
May 11, 2018: International Journal of Environmental Research and Public Health
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