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Drug use in the elderly

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https://www.readbyqxmd.com/read/29142956/hypertension-control-apparent-treatment-resistance-and-outcomes-in-the-elderly-population-with-chronic-kidney-disease
#1
Jean Kaboré, Marie Metzger, Catherine Helmer, Claudine Berr, Christophe Tzourio, Tilman B Drueke, Ziad A Massy, Bénédicte Stengel
Introduction: Chronic kidney disease (CKD) is often associated with poor hypertension control and treatment resistance, but whether CKD modifies the effect of hypertension control on outcomes is unknown. Methods: We studied 10-year mortality and cardiovascular events according to hypertension control status and CKD (glomerular filtration rate <60 ml/min/1.73m(2)) in 4262 community-dwelling individuals (40% men) more than 65 years of age. Results: At baseline, 19% had CKD, and 31...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29141224/genetic-and-genomic-characterization-of-462-melanoma-patient-derived-xenografts-tumor-biopsies-and-cell-lines
#2
Bradley Garman, Ioannis N Anastopoulos, Clemens Krepler, Patricia Brafford, Katrin Sproesser, Yuchao Jiang, Bradley Wubbenhorst, Ravi Amaravadi, Joseph Bennett, Marilda Beqiri, David Elder, Keith T Flaherty, Dennie T Frederick, Tara C Gangadhar, Michael Guarino, David Hoon, Giorgos Karakousis, Qin Liu, Nandita Mitra, Nicholas J Petrelli, Lynn Schuchter, Batool Shannan, Carol L Shields, Jennifer Wargo, Brandon Wenz, Melissa A Wilson, Min Xiao, Wei Xu, Xaiowei Xu, Xiangfan Yin, Nancy R Zhang, Michael A Davies, Meenhard Herlyn, Katherine L Nathanson
Tumor-sequencing studies have revealed the widespread genetic diversity of melanoma. Sequencing of 108 genes previously implicated in melanomagenesis was performed on 462 patient-derived xenografts (PDXs), cell lines, and tumors to identify mutational and copy number aberrations. Samples came from 371 unique individuals: 263 were naive to treatment, and 108 were previously treated with targeted therapy (34), immunotherapy (54), or both (20). Models of all previously reported major melanoma subtypes (BRAF, NRAS, NF1, KIT, and WT/WT/WT) were identified...
November 14, 2017: Cell Reports
https://www.readbyqxmd.com/read/29141054/managing-seborrheic-keratoses-evolving-strategies-for-optimizing-patient-outcomes
#3
Geraldine Cheyana Ranasinghe, Adam J Friedman
<p>The seborrheic keratosis is the most common benign skin tumor of middle-aged and elderly adults, affecting nearly 83 million individuals in the US alone. Although these are benign lesions, many patients still undergo some form of treatment. Clinicians are frequently presented with a challenge when determining whether to remove a seborrheic keratosis, and which treatment modality to use when doing so. The most commonly used method of removal is cryotherapy, however there are numerous other options that can be employed with varying degrees of efficacy...
November 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#4
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29139254/-clinical-analysis-of-cervus-and-cucumis-polypeptide-injection-for-lumbar-vertebrae-diseases-based-on-real-world-hospital-information-system
#5
Ming-Yue Gao, Yan-Ming Xie, Yuan-Yuan Li, Yin Zhang, Yan Zhuang
To analyze the clinical drug use characteristics and medication rules of cervus and cucumis polypeptide injection (CCP injection) for the patients with lumbar vertebra diseases. Based on the electronic medical data of 6 990 patients with CCP injection for lumbar vertebra diseases from 25 first-class hospitals over the whole country from 2004, statistical analysis was conducted for their general information, diagnostic information, orders information, laboratory test information and treatment results. The results showed that the age distribution was highest in patients aged 45 to 64 (3 883, 55...
August 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29138901/-which-factors-are-associated-with-the-use-of-potentially-inadequate-medications-pim-in-the-elderly-results-from-the-german-health-interview-and-examination-survey-degs1
#6
Heinz G Endres, Petra Kaufmann-Kolle, Hildtraud Knopf, Petra A Thürmann
BACKGROUND: Recent studies demonstrate a relationship between the prescription of potentially inappropriate medications (PIM) for patients 65 years or older and an increased risk for adverse events, in particular hospitalisations. The RKI conducted DEGS1-Survey ("German health interview and examination survey for adults") provides a representative sample of the target population to identify determinants for PIM use. OBJECTIVE: The aim of this study was to determine characteristics of older persons in Germany, who currently use PIM, and if there are subpopulations among older persons with a particularly high PIM use...
November 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29133323/characteristics-and-healthcare-utilisation-patterns-of-high-cost-beneficiaries-in-the-netherlands-a-cross-sectional-claims-database-study
#7
Joost Johan Godert Wammes, Marit Tanke, Wilma Jonkers, Gert P Westert, Philip Van der Wees, Patrick Pt Jeurissen
OBJECTIVE: To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%-5% high-cost beneficiaries in the Netherlands. DESIGN: Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most cost-incurring condition per beneficiary and expensive treatment use. SETTING: Dutch curative health system, a health system with universal coverage...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29128115/chronic-use-of-proton-pump-inhibitors-adverse-events-and-potential-biological-mechanisms-a-translational-analysis
#8
Farid Kheloufi, Diane Frankel, Elise Kaspi, Marion Lepelley, Michel Mallaret, Quentin Boucherie, Patrice Roll, Joelle Micallef
Proton pump inhibitors (PPIs) are among the most frequently prescribed drugs. Even if PPI are usually considered as safe, there is a growing concern for a range of adverse effects of chronic PPI therapy often in the absence of appropriate indications. We propose, after a summary of renal, cardiovascular and neurological complications (dementia, chronic kidney disease, myocardial infarction and stroke), an integrative overview of the potential biological mechanisms involved. Eleven positive pharmacoepidemiological studies, mainly based on health insurance database linkage to hospital database, reported an increased risk of complications associated to PPI use and often a graded association suggesting also a possible dose-response relationship...
October 14, 2017: Thérapie
https://www.readbyqxmd.com/read/29125269/direct-oral-anticoagulants-use-in-elderly-patients-with-non-valvular-atrial-fibrillation-state-of-evidence
#9
Giulia Benedetti, Matteo Neccia, Luciano Agati
Non-valvular atrial fibrillation (NVAF) increases the risk of stroke by three- to five-fold, especially in elderly patients, creating a huge burden on medical system as well as a negative impact on patients lives. Balancing efficacy and bleeding risk is a challenge when considering anticoagulation therapy in elderly patients, because of their frequent high risk of both stroke and bleeding. Real world data reveal the underuse of anticoagulation in the elderly, especially due to physicians' fear of bleeding, often neglecting the thromboembolic risk...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29124985/pharmacotherapy-and-motor-recovery-after-stroke
#10
Luciano Viale, Natalia Paola Catoira, Guillermo Di Girolamo, Claudio Daniel González
Stroke is one of the most prevalent neurological diseases worldwide, especially among the elderly population. There are various mechanisms that enhance motor recovery after a stroke. In clinical practice, we have the opportunity to enhance plasticity by designing specific rehabilitation programs. Areas covered: There are a variety of drugs commonly administered to people after the acute phase of a stroke. These drugs may modify motor performance. Herein reviewed is the evidence concerning motor enhancement or decline in stroke patients, produced by drugs commonly used in rehabilitation settings...
November 10, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29124005/massive-hemoptysis-from-rasmussen-s-aneurysm-in-active-pulmonary-tuberculosis-a-case-report-of-successful-treatment-with-bronchial-artery-embolization
#11
K V Rajamannar, Hemanth Kilaru, Srujana Aravelly, Ananta Ram Gudipati, Satish Chandra Kilaru
Rasmussen's aneurysm, a very rare complication of active pulmonary tuberculosis (TB), is a pulmonary artery aneurysm adjacent to or within a tuberculous cavity. It may lead to rupture and life threatening massive hemoptysis, an uncommon but challenging medico-surgical emergency. This complication warrants attention in view of the resurgence of tuberculosis and increasing occurrence of multi-drug resistant TB, especially in resource-poor, high-TB burden countries like India. We present a case of an elderly man who presented to the emergency room with low-grade fever, cough and hemoptysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29122534/influence-of-antithrombotic-agents-on-recurrence-rate-and-clinical-outcome-in-patients-operated-for-chronic-subdural-hematoma
#12
Tammam Abboud, Lasse Dührsen, Christina Gibbert, Manfred Westphal, Tobias Martens
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common pathology encountered in neurosurgical practice, especially in elderly patients, who frequently require antithrombotic agents. The aim of this study was to investigate the influence of antithrombotic agents on recurrence rates and clinical outcomes in patients operated for cSDH. METHODS: A cohort of patients operated for cSDH at one center during a 5 years period was analyzed retrospectively. Presenting symptoms, coagulation testing, history of antithrombotic agents and comorbidities were obtained from the patient charts...
November 6, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29121723/atrial-fibrillation-and-use-of-antithrombotic-medications-in-older-people-a-population-based-study
#13
Mozhu Ding, Laura Fratiglioni, Kristina Johnell, Johan Fastbom, Maria Ljungdahl, Chengxuan Qiu
BACKGROUND: Trends in the use of antithrombotic drugs in elderly patients with atrial fibrillation (AF) are largely unknown. We estimated the prevalence of AF in an older population, and examined whether use of anticoagulant and antiplatelet drugs in older AF patients has changed over time. METHODS: Data from the population-based Swedish National study on Aging and Care in Kungsholmen (n=3363, age≥60years, 64.9% women) were used (2001-2004 and 2007-2010). AF cases were identified through 12-lead electrocardiogram, physician examinations, and patient register records (ICD-10 code I48)...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29121033/identification-of-seniors-at-risk-scale-as-a-simple-tool-of-elderly-patients-assessment-in-an-acute-hospital-department
#14
Anna Gałuszewska, Barbara Gryglewska, Stanisław Górski, Anna Kańtoch, Tomasz Grodzicki
INTRODUCTION: e aim of the study was to evaluate the usefulness of Identification of Seniors at Risk (ISAR) scale among elderly patients admitted to the department of internal medicine. MATERIAL AND METHODS: The ISAR score was performed among patients aged >59 years a er admission to the hospital ward. Data from medical history about diseases, taken medicines, falls, length of hospital stay and mortality were compared in patients with ISAR score of 0-1 and over 1 and in subjects with and without history of falls...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29119468/clinical-decision-support-and-optional-point-of-care-testing-of-renal-function-for-safe-use-of-antibiotics-in-elderly-patients-a-retrospective-study-in-community-pharmacy-practice
#15
Mette Heringa, Annemieke Floor-Schreudering, Peter A G M De Smet, Marcel L Bouvy
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a clinical decision support system (CDSS) for seven antibiotics. Alerts were generated during prescription processing in the case of previously registered renal impairment and when no information on renal function was available for patients aged 70 and over...
November 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29115454/mycoleptodonoides%C3%A2-aitchisonii-suppresses-asthma-via-th2-and-th1-cell-regulation-in-an-ovalbumin%C3%A2-induced-asthma-mouse-model
#16
Soon-Young Lee, Chun-Sik Bae, Ji-Hye Seo, Seung Sik Cho, Min-Suk Bae, Deuk-Sil Oh, Dae-Hun Park
Asthma is a chronic respiratory disease related to hyper‑responsiveness. The majority of patients suffer mild symptoms, however, some cases, especially in the young and the elderly, can lead to death by apnea. Mycoleptodonoides atichisonii (M. atichisonii) is an edible mushroom that has previously been reported to possess several bioactive properties, such as the synthesis of nerve growth factors, anti‑obesity effects and the ability to prevent cell death. In the current study, the authors evaluated the anti‑asthmatic effects of M...
October 26, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29109625/postoperative-delirium-in-elderly-citizens-and-current-practice
#17
REVIEW
Siddareddygari Velayudha Reddy, Jawaharlal Narayanasa Irkal, Ananthapuram Srinivasamurthy
Postoperative delirium (POD) represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29105991/hypertension-and-frailty-in-older-adults
#18
Ivan Aprahamian, Eduardo Sassaki, Marília F Dos Santos, Rafael Izbicki, Rafael C Pulgrossi, Marina M Biella, Ana Camila N Borges, Marcela M Sassaki, Leonardo M Torres, Ícaro S Fernandez, Olívia A Pião, Paula L M Castro, Pedro A Fontenele, Mônica S Yassuda
The association between hypertension and frailty syndrome in older adults remains unclear. There is scarce information about the prevalence of hypertension among frail elderly patients or on its relationship with frailty. Up to one quarter of frail elderly patients present without comorbidity or disability, yet frailty is a leading cause of death. The knowledge and better control of frailty risk factors could influence prognosis. The present study evaluated: (1) the prevalence of hypertension in robust, prefrail, and frail elderly; and (2) factors that might be associated with frailty including hypertension...
November 5, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29103240/the-need-for-medication-reconciliation-increases-with-age
#19
Rima Rappaport, Zeev Arinzon, Jacob Feldman, Shiloh Lotan, Rachel Heffez-Aizenfeld, Yitshal Berner
BACKGROUND: Medication reconciliation (MR) at hospital admission, transfer, and discharge has been designated as a required hospital practice to reduce adverse drug events. OBJECTIVES: To perform MR among elderly patients admitted to the hospital and to determine factors that influence differences between the various lists of prescribed drugs as well as their actual consumption. METHODS: We studied patients aged 65 years and older who had been admitted to the hospital and were taking at least one prescription drug...
October 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29103159/model-based-optimization-of-g-csf-treatment-during-cytotoxic-chemotherapy
#20
Sibylle Schirm, Christoph Engel, Sibylle Loibl, Markus Loeffler, Markus Scholz
PURPOSE: Although G-CSF is widely used to prevent or ameliorate leukopenia during cytotoxic chemotherapies, its optimal use is still under debate and depends on many therapy parameters such as dosing and timing of cytotoxic drugs and G-CSF, G-CSF pharmaceuticals used and individual risk factors of patients. METHODS: We integrate available biological knowledge and clinical data regarding cell kinetics of bone marrow granulopoiesis, the cytotoxic effects of chemotherapy and pharmacokinetics and pharmacodynamics of G-CSF applications (filgrastim or pegfilgrastim) into a comprehensive model...
November 4, 2017: Journal of Cancer Research and Clinical Oncology
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