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https://www.readbyqxmd.com/read/28944569/prognostic-factors-and-treatment-outcomes-for-patients-with-fournier-s-gangrene-a-retrospective-study
#1
Kyung Sook Hong, Hee Jung Yi, Ryung-Ah Lee, Kwang Ho Kim, Soon Sup Chung
Fournier's gangrene is a gas-forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics...
September 25, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28942708/laparoscopic-roux-en-y-gastric-bypass-in-elderly-patients-60%C3%A2-years-or-older-a-meta-analysis-of-comparative-studies
#2
S Giordano, M Victorzon
BACKGROUND AND AIMS: Elderly patient might experience an increased risk of complications after laparoscopic Roux-en-Y gastric bypass. We aimed to perform a meta-analysis of comparative studies on this issue in patients aged 60 years or older. MATERIAL AND METHODS: A systematic literature search was performed. Medline, Cochrane Library, Embase, Scopus, and Google Scholar were searched until July 2016 for studies on outcomes of laparoscopic Roux-en-Y gastric bypass in elderly versus younger patients...
September 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28942658/neighborhood-environment-residential-satisfaction-and-depressive-symptoms-among-older-adults-in-residential-care-homes
#3
Susu Liu, Zheng Ouyang, Alice M Chong, Haitao Wang
Burgeoning evidence has shown that neighborhood environments are related to depressive symptoms in the older population. Older adults living in residential care homes may be more vulnerable to environmental characteristics. The current study sought to understand how institutionalized older adults relate to environmental factors and residential satisfaction in terms of depressive symptoms. Data were collected from a cross-sectional national survey of 1,429 Chinese elders living in residential care homes. The findings reveal that 46...
January 1, 2017: International Journal of Aging & Human Development
https://www.readbyqxmd.com/read/28942203/potentially-inappropriate-medication-association-between-the-use-of-antidepressant-drugs-and-the-subsequent-risk-for-dementia
#4
Kathrin Heser, Tobias Luck, Susanne Röhr, Birgitt Wiese, Hanna Kaduszkiewicz, Anke Oey, Horst Bickel, Edelgard Mösch, Siegfried Weyerer, Jochen Werle, Christian Brettschneider, Hans-Helmut König, Angela Fuchs, Michael Pentzek, Hendrik van den Bussche, Martin Scherer, Wolfgang Maier, Steffi G Riedel-Heller, Michael Wagner
BACKGROUND: Potentially inappropriate medication (PIM) is associated with an increased risk for detrimental health outcomes in elderly patients. Some antidepressant drugs are considered as PIM, but previous research on the association between antidepressants and subsequent dementia has been inconclusive. Therefore, we investigated whether the intake of antidepressants, particularly of those considered as PIM according to the Priscus list, would predict incident dementia. METHODS: We used data of a prospective cohort study of non-demented primary care patients (n = 3239, mean age = 79...
September 14, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28940368/cerebral-oximetry-and-postoperative-delirium-after-cardiac-surgery-a-randomised-controlled-trial
#5
L Lei, R Katznelson, L Fedorko, J Carroll, H Poonawala, M Machina, R Styra, V Rao, G Djaiani
Postoperative delirium is associated with increased morbidity and mortality. We hypothesised that restoration of regional cerebral oxygen desaturation would reduce the incidence of postoperative delirium in elderly patients after cardiac surgery. After institutional ethics review board approval and informed consent, a double-blinded, prospective, randomised, controlled trial was conducted in patients ≥ 60 years of age undergoing cardiac surgery with cardiopulmonary bypass. In the intervention group, an algorithm was commenced if regional cerebral oxygen saturation decreased below 75% of baseline value for 1 min or longer...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28939983/-drug-therapy-for-older-people-choosing-wisely
#6
REVIEW
Martin Wehling
Elderly people are the most rapidly growing sector of our society. Due to their multimorbidity they are exposed to a multitude of medications, which are accompanied by chances and risks. The problem of inappropriate medication in the elderly is exacerbated by the fact that only a holistic view can help these patients and that this is predominantly the responsibility of the general practitioner. The closely measured paid contact time is often insufficient to optimize complex medications. Clinically successfully tested aids in the form of lists give reason for hope: in particular, the positive/negative assessment of limitations of the elderly with respect to drugs by the STOPP/START criteria and the FORTA classification are clinically successful aids...
September 22, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28939365/acute-cholecystitis-in-elderly-patients-a-case-for-early-cholecystectomy
#7
C S Loozen, B van Ramshorst, H C van Santvoort, D Boerma
BACKGROUND: Recent advances in laparoscopic techniques and perioperative care have changed the indications for surgery in elderly patients. Consequently, the willingness to offer early surgery for acute cholecystitis continues to increase. This study aims to assess the perioperative outcome of early cholecystectomy for acute calculous cholecystitis in elderly patients. PATIENTS AND METHODS: All consecutive patients treated by early cholecystectomy for acute calculous cholecystitis in a major teaching hospital, between January 2002 and November 2016, were retrospectively analyzed...
September 19, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28939010/-evaluation-of-the-prescription-of-proton-pump-inhibitors-in-persons-aged-75years-and-older-in-a-geriatric-acute-care-unit
#8
Mélanie Dipanda, Laureline Pioro, Maxime Buttard, Philippe d'Athis, Sanaa Asgassou, Sophie Putot, Martha Deïdda, Caroline Laborde, Alain Putot, Patrick Manckoundia
INTRODUCTION AND OBJECTIVES: Proton pump inhibitors (PPI) are widely prescribed in France and could be responsible for adverse drug reactions especially in elderly persons (EP). In order to reduce the misuse of PPI and the excess cost to the Social Security Agency, the French health authorities (Haute Autorité de santé [HAS]) have published strict guidelines for their prescription. We conducted a study in EP to determine the proportion of PPI prescriptions outside HAS guidelines. METHOD: This was a prospective, single-centre observational study in persons aged≥75 years admitted to a geriatric acute-care unit over a period of 6months...
July 29, 2017: Thérapie
https://www.readbyqxmd.com/read/28938892/allocation-of-home-care-services-by-municipalities-in-norway-a-document-analysis
#9
Solrun G Holm, Terje A Mathisen, Torill M Sæterstrand, Berit S Brinchmann
BACKGROUND: In Norway, elder care is primarily a municipal responsibility. Municipal health services strive to offer the 'lowest level of effective care,' and home healthcare services are defined as the lowest level of care in Norway. Municipalities determine the type(s) of service and the amount of care applicants require. The services granted are outlined in an individual decision letter, which serves as a contract between the municipality and the home healthcare recipient. The purpose of this study was to gain insight into the scope and duration of home healthcare services allocated by municipalities and to determine where home care recipients live in relation to home healthcare service offices...
September 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28937935/the-impact-of-the-2006-massachusetts-health-care-reform-law-on-spine-surgery-patient-payer-mix-status-and-age
#10
Nicolas W Villelli, Hong Yan, Jian Zou, Nicholas M Barbaro
OBJECTIVE Several similarities exist between the Massachusetts health care reform law of 2006 and the Affordable Care Act (ACA). The authors' prior neurosurgical research showed a decrease in uninsured surgeries without a significant change in surgical volume after the Massachusetts reform. An analysis of the payer-mix status and the age of spine surgery patients, before and after the policy, should provide insight into the future impact of the ACA on spine surgery in the US. METHODS Using the Massachusetts State Inpatient Database and spine ICD-9-CM procedure codes, the authors obtained demographic information on patients undergoing spine surgery between 2001 and 2012...
September 15, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28937659/assessing-the-allocation-of-special-elderly-nursing-homes-in-tokyo-japan
#11
Ninglong You, Zhenjiang Shen, Tatsuya Nishino
Social welfare and public health departments require reliable assessments to enhance the rationality of phased construction of special elderly nursing homes (SENHs). This paper aims to assess the allocation of SENHs based on a beds-needed index for SENHs (BNIS). This may help departments determine the priority for approving locations of SENHs more accurately with a limited budget. Traditional assessments in Tokyo use the sphere of welfare, ward, and sphere of daily life as spatial units for estimating beds-to-elderly population ratios...
September 22, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28936626/the-impact-of-frailty-on-icu-and-30-day-mortality-and-the-level-of-care-in-very-elderly-patients-%C3%A2-%C3%A2-80%C3%A2-years
#12
Hans Flaatten, Dylan W De Lange, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Ariane Boumendil, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agwald Öhman, Bernardo Bollen Pinto, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zaferidis, Bertrand Guidet
PURPOSE: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. METHODS: A transnational prospective cohort study from October 2016 to May 2017 with 30 days follow-up was set up by the European Society of Intensive Care Medicine...
September 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936066/cognitive-impairment-in-rural-elderly-population-in-ecuador
#13
Xavier Wong-Achi, Gabriela Egas, Dayana Cabrera
INTRODUCTION: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. MATERIALS AND METHODS: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28934907/the-use-of-assistive-technologies-after-stroke-is-debunking-the-myths-about-the-elderly
#14
Marija Tomšič, Barbara Domajnko, Melita Zajc
Background Through the concept of ageism, we highlight and explain how the society prejudices the elderly. WHO classifies 12 most common stereotypes pertaining to old age. Elderly people are being excluded from social life due to their chronological age rather than any actual reduced physical and/or mental ability. Some of these stereotypes are directly related to the (un)willingness and the ability of the elderly to use technology in everyday life. Objectives The study presented in this article aims to explain the phenomenon of technology use among elderly people who had had a stroke...
September 22, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28933772/horizontal-inequity-in-health-care-utilization-among-the-middle-aged-and-elderly-in-china
#15
Chaofan Li, Lei Dou, Haipeng Wang, Shanshan Jing, Aitian Yin
BACKGROUND: Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. METHODS: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization...
July 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28933013/role-of-ramelteon-in-reduction-of-as-needed-antipsychotics-in-elderly-patients-with-delirium-in-a-general-hospital-setting
#16
Aaron Pinkhasov, Sara A James, Melissa Fazzari, Deepan Singh, Sum Lam
BACKGROUND AND OBJECTIVE: Abnormalities in melatonin levels have been linked to delirium. This dysregulation may be offset with the use of ramelteon, a melatonin receptor agonist. The purpose of this study was to evaluate the role of ramelteon in decreasing the need for as-needed (PRN) use of antipsychotics in elderly patients with delirium. METHODS: This was a single-center, retrospective study involving 488 patients who were placed on constant observation and received care by psychiatric service from May 2015 through October 2015...
September 20, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28932975/the-effect-of-a-geriatric-evaluation-on-treatment-decisions-for-older-patients-with-colorectal-cancer
#17
N M Verweij, E T D Souwer, A H W Schiphorst, H A Maas, J E A Portielje, A Pronk, F van den Bos, M E Hamaker
BACKGROUND: Treating elderly colorectal cancer patients can be challenging. It is very important to carefully weigh the risks and benefits of potential treatments in individual patients. This treatment decision making can be guided by geriatric consultation. Our aim was to assess the effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer. METHODS: Colorectal cancer patients who were referred for a geriatric consultation between 2013 and 2015 in three Dutch teaching hospitals were included in a prospective database...
September 20, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28932722/the-first-year-after-colorectal-surgery-in-the-elderly
#18
Verena N N Kornmann, Jeroen L A van Vugt, Anke B Smits, Bert van Ramshorst, Djamila Boerma
PURPOSE: Surgery for colorectal malignancy is increasingly being performed in the elderly. Little is known about the impact of complications on late mortality. This study aimed to analyze whether a complicated postoperative course affects the 1-year survival in elderly patients. METHODS: All consecutive patients older than 75 years of age who underwent colorectal cancer surgery between January 2009 and April 2013 were included in this study. The main outcome was mortality at 1 year after surgery...
August 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28932318/khan-krum-the-fearsome-a-noble-bulgarian-with-iris-fibroma
#19
Georgi Tchernev, Hristo Mangarov, Anastasiya Atanasova Chokoeva
A 40-year-old Caucasian, the otherwise healthy male patient, presented with 3-years history of a prominent tumor-like formation, located on his back, without subjective complaints. Initially, the lesion was 1-2 cm in size but gradually increased to a visible-pronounced tumor-like formation. No other dermatologic diseases, neither other known abnormalities were reported for the medical and family history. Softly-elastic on palpation tumor-like formation was established in the left infrascapular area of the back, measuring 8/9 cm in diameter...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28932158/the-burden-perceived-by-informal-caregivers-of-the-elderly-in-saudi-arabia
#20
Sulaiman A Alshammari, Abdullah A Alzahrani, Khaled A Alabduljabbar, Abdulaziz A Aldaghri, Yazeed A Alhusainy, Mohammed A Khan, Rakan A Alshuwaier, Ismail N Kariz
OBJECTIVES: The objective of this study was to discover the characteristics of informal caregivers of elderly patients; to determine the socioeconomic, psychological, and physical consequences facing informal caregivers; and to measure their burdens and needs. MATERIALS AND METHODS: This study was a cross-sectional survey of informal caregivers of elderly patients. Participants were recruited from different hospitals and primary care clinics in Riyadh, Saudi Arabia...
September 2017: Journal of Family & Community Medicine
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