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Elderly medicine

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https://www.readbyqxmd.com/read/29665778/characteristics-of-elderly-patients-with-polypharmacy-who-refuse-to-participate-in-an-in-hospital-deprescribing-intervention-a-retrospective-cross-sectional-study
#1
Junpei Komagamine, Kenichi Sugawara, Kazuhiko Hagane
BACKGROUND: Few studies have evaluated the characteristics of elderly patients with polypharmacy refusing deprescribing. The aim of this study was to evaluate the prevalence of potentially inappropriate medication (PIM) use in elderly patients accepting and refusing a deprescribing intervention and to investigate factors associated with deprescribing refusal. METHODS: We conducted a retrospective cross-sectional study by analyzing the electronic medical records from a single hospital...
April 17, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29665383/impact-of-aging-alzheimer-s-disease-and-parkinson-s-disease-on-the-blood-brain-barrier-transport-of-therapeutics
#2
Yijun Pan, Joseph A Nicolazzo
Older people are at greater risk of medicine-induced toxicities resulting from either increased drug sensitivity or age-related pharmacokinetic changes. The scenario is further complicated with the two most prevalent age-related neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD). With aging, AD and PD, there is growing evidence of altered structure and function of the blood-brain barrier (BBB), including modifications to tight junctions and efflux transporters, such as P-glycoprotein...
April 14, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29665346/chronological-age-as-factor-influencing-the-dental-implant-osseointegration-in-the-jaw-bone
#3
Jakub Papež, Taťjana Dostálová, Karel Chleborád, Pavel Kříž, Jakub Strnad
The objectives of this study were to evaluate osseointegration of dental implant in the jaw bone in the young and elderly population and comparing the results to assess indicators and risk factors as age for the success or failure of dental implants. A retrospective study of 107 implants (Impladent, LASAK, Czech Republic) was prepared. The patients at implants surgery were divided in three groups. The patients were followed-up for a 7-year period. We evaluated osseointegration from long term point of view as a change of marginal bone levels close to dental implant...
2018: Prague Medical Report
https://www.readbyqxmd.com/read/29661504/stress-induced-hyperglycemia-on-complications-in-non-critically-elderly-hospitalized-patients
#4
F J Carrasco-Sánchez, J Carretero-Gómez, R Gómez-Huelgas, M A Garcia-Ordoñez, M V Pardo-Ortega, B de Escalante-Yanguela, L Mateos-Polo, F Formiga, J Ena
AIMS: Hospital complications and hyperglycemia are common in elderly patients during hospitalization. Our aim was to analyze the relationship between hyperglycemia and hospital complications in an ageing population. METHODS: We conducted an observational study to evaluate the association between maximum blood glucose (MBG) levels and hospital complications. Patients were stratified according to the quartiles of MBG levels. Diabetes mellitus (DM) was determined by patient history and/or admission glycated hemoglobin (HbA1c) level ≥6...
April 13, 2018: Revista Clínica Española
https://www.readbyqxmd.com/read/29657212/mortality-in-the-elderly-with-acute-kidney-injury-in-an-internal-medicine-department-in-abidjan-cote-d-ivoire
#5
Hubert Kouamé Yao, Allah Yves Omer Binan, Serge-Didier Konan, Koffi Justin N'Da, Sery Patrick Diopoh
Acute kidney injury (AKI) in the elderly is characterized by high mortality. The objective of this study is to identify the causes of death in the elderly with AKI. This is a prospective cohort study with a descriptive purpose which was carried out during the period from January 2009 to December 2014 in the Department of Nephrology-Internal Medicine of Treichville University Hospital. The diagnosis of AKI was made on the basis of serum creatinine (SCr) values determined during hospitalization, according to KDIGO classification...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29650075/clinical-skills-assessment-in-the-twenty-first-century
#6
REVIEW
Andrew Elder
Clinical skills remain fundamental to the practice of medicine and form a core component of the professional identity of the physician. However, evidence exists to suggest that the practice of some clinical skills is declining, particularly in the United States. A decline in practice of any skill can lead to a decline in its teaching and assessment, with further decline in practice as a result. Consequently, assessment not only drives learning of clinical skills, but their practice. This article summarizes contemporary approaches to clinical skills assessment that, if more widely adopted, could support the maintenance and reinvigoration of bedside clinical skills...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29643543/-airway-foreign-body-caused-by-aspiration-of-artificial-nasal-sponge-a-case-report
#7
T X Fu, X Wang, M L Liu
57-year-old male was admitted to hospital for severe headache and seizure attacks on November 6th, 2016. After radiology and spinal fluid examination, he was diagnosed with viral encephalitis and treated with antiviral medicine, antibiotics and mannitol, but he was in sustained unconsciousness and weak in expectorating. The patient was given oxygen through artificial nasal after bedside tracheotomy. At 1:00 am on January 12th, 2016, there was a sudden drop in blood pressure, heart rate and oxygen saturation with left lung breath sounds slightly lower than the other side...
April 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29642620/rhodobacter-sphaeroides-extract-lycogen%C3%A2-attenuates-testosterone-induced-benign-prostate-hyperplasia-in-rats
#8
Chiang-Ting Wang, Ya-Yun Wang, Wen-Sheng Liu, Chun-Ming Cheng, Kuo-Hsun Chiu, Li-Lian Liu, Xue-Zhu Liu, Zhi-Hong Wen, Ya-Huey Chen, Tsung-Ming Chen
Benign prostate hyperplasia (BPH) is one of the most common urological problems in mid-aged to elderly men. Risk factors of BPH include family history, obesity, type 2 diabetes, and high oxidative stress. The main medication classes for BPH management are alpha blockers and 5α-reductase inhibitors. However, these conventional medicines cause adverse effects. Lycogen™, extracted from Rhodobacter sphaeroides WL-APD911, is an anti-oxidant and anti-inflammatory compound. In this study, the effect of Lycogen™ was evaluated in rats with testosterone-induced benign prostate hyperplasia (BPH)...
April 10, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29625779/b-type-natriuretic-peptide-may-predict-prognosis-in-older-adults-admitted-with-a-diagnosis-other-than-heart-failure
#9
S Di Marca, A Rando, E Cataudella, A Pulvirenti, S Alaimo, V Terranova, T Corriere, M Pisano, R Di Quattro, M L Ronsisvalle, C M Giraffa, M Giordano, B Stancanelli, L Malatino
BACKGROUND AND AIMS: The diagnosis of heart failure (HF) in elderly patients is often difficult, due to overlap of typical signs and symptoms with those of comorbidities. B-type Natriuretic Peptide (BNP) predicts diagnosis and prognosis of HF, but little is known on its predictive role of short-term prognosis when admission diagnosis is other than HF. METHODS AND RESULTS: We prospectively recruited 404 consecutive patients (aged≥65 years) hospitalized in the Unit of Internal Medicine, University of Catania, Catania, Italy, with an admission diagnosis other than HF...
March 2, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29618397/nursing-home-physicians-discuss-caring-for-elderly-residents-an-exploratory-study
#10
Albert Banerjee, Robert James, Margaret McGregor, Joel Lexchin
ABSTRACTDespite the increasing complexity of nursing home care, the role of physicians caring for residents is largely unexplored. This international, exploratory study sought to learn about physicians' roles, responsibilities, and tasks as well as investigate the unique qualities of medical practice in nursing homes. We conducted interviews with 18 physicians, who reported making important contributions to the quality of resident care, including clarifying the goals of care, working to reduce unnecessary medication and hospitalization, as well as contributing to staff education...
April 5, 2018: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/29615993/antibacterial-activity-of-glutathione-stabilized-silver-nanoparticles-against-campylobacter-multidrug-resistant-strains
#11
Jose M Silvan, Irene Zorraquin-Peña, Dolores Gonzalez de Llano, M Victoria Moreno-Arribas, Adolfo J Martinez-Rodriguez
Campylobacter is the leading cause of bacterial diarrheal disease worldwide. Although most episodes of campylobacteriosis are self-limiting, antibiotic treatment is usually needed in patients with serious enteritis, and especially in childrens or the elderly. In the last years, antibiotic resistance in Campylobacter has become a major public health concern and a great interest exists in developing new antimicrobial strategies for reducing the impact of this food-borne pathogen on human health. Among them, the use of silver nanoparticles as antibacterial agents has taken on increased importance in the field of medicine...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29615016/using-differential-item-functioning-to-evaluate-potential-bias-in-a-high-stakes-postgraduate-knowledge-based-assessment
#12
David Hope, Karen Adamson, I C McManus, Liliana Chis, Andrew Elder
BACKGROUND: Fairness is a critical component of defensible assessment. Candidates should perform according to ability without influence from background characteristics such as ethnicity or sex. However, performance differs by candidate background in many assessment environments. Many potential causes of such differences exist, and examinations must be routinely analysed to ensure they do not present inappropriate progression barriers for any candidate group. By analysing the individual questions of an examination through techniques such as Differential Item Functioning (DIF), we can test whether a subset of unfair questions explains group-level differences...
April 3, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29609649/ethnomycological-study-in-the-kilum-ijim-mountain-forest-northwest-region-cameroon
#13
N A Teke, T R Kinge, E Bechem, T M Nji, L M Ndam, A M Mih
BACKGROUND: Majority of the people in rural areas depend on traditional fungi-based medicines to combat different illnesses. This ethnomycological survey was undertaken to document the traditional knowledge of mushrooms among the communities in the Kilum-Ijim mountain forest reserve. Although macrofungi are exploited for food and medicine, their ethnomycological knowledge has not been documented in this ecosystem. METHODS: A field study was carried out between 2014 and 2015; 14 mushrooms used by the local communities were collected and identified using the polymorphism of the ribosomal ITS1, 5...
April 2, 2018: Journal of Ethnobiology and Ethnomedicine
https://www.readbyqxmd.com/read/29593860/potential-drug-drug-interactions-with-direct-oral-anticoagulants-in-elderly-hospitalized-patients
#14
Heather L Forbes, Thomas M Polasek
Background: To determine the prevalence and nature of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in elderly hospitalized patients. Methods: This was a retrospective observational study. Inclusion criteria were: aged over 65 years; taking apixaban, rivaroxaban or dabigatran; and admitted to the Repatriation General Hospital between April 2014 and July 2015. A list of clinically relevant 'perpetrator' drugs was compiled from product information, the Australian Medicines Handbook, the Australian National Prescribing Service resources, and local health network guidelines...
October 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29584506/ais-scores-in-spine-and-spinal-cord-trauma-epidemiological-considerations
#15
Dennis Maiman, Frank Pintar, Waqar Malik, Narayan Yoganandan
BACKGROUND: The Abbreviated Injury Scale (AIS) is an internationally accepted coding system created by the Association for the Advancement of Automotive Medicine, utilized to code traumatic injuries as a function of severity, the latter often defined as mortality risk. Periodic reassessment of that risk is prudent, in light of advances in health care and relationship of nonanatomic factors to death. OBJECTIVE: The objective of this study was to reevaluate the risk of death associated with spine fractures with and without neurologic deficit, age factors associated with it, and the impact of hospital coding on the accuracy of these efforts...
February 28, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29581202/real-world-effects-of-medications-for-chronic-obstructive-pulmonary-disease-protocol-for-a-uk-population-based-non-interventional-cohort-study-with-validation-against-randomised-trial-results
#16
Kevin Wing, Elizabeth Williamson, James R Carpenter, Lesley Wise, Sebastian Schneeweiss, Liam Smeeth, Jennifer K Quint, Ian Douglas
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a progressive disease affecting 3 million people in the UK, in which patients exhibit airflow obstruction that is not fully reversible. COPD treatment guidelines are largely informed by randomised controlled trial results, but it is unclear if these findings apply to large patient populations not studied in trials. Non-interventional studies could be used to study patient groups excluded from trials, but the use of these studies to estimate treatment effectiveness is in its infancy...
March 25, 2018: BMJ Open
https://www.readbyqxmd.com/read/29580273/effect-of-total-exemption-from-medical-service-co-payments-on-potentially-inappropriate-medication-use-among-elderly-ambulatory-patients-in-a-single-center-in-japan-a-retrospective-cross-sectional-study
#17
Junpei Komagamine, Kazuhiko Hagane
OBJECTIVE: The effect of total exemption from medical service co-payments on drug prescribing practices has not been extensively evaluated. We conducted a retrospective cross-sectional study to evaluate the effect of total exemption from medical service co-payments on potentially inappropriate medication (PIM) and benzodiazepine use in elderly ambulatory patients. We defined PIM based on the Beers Criteria. RESULTS: Six hundred seventy-one consecutive patients aged 65 years or older who routinely visited internal medicine physicians were included...
March 27, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29572406/is-routine-measurement-of-tsh-hormone-in-hospitalized-patients-necessary
#18
Amir Bashkin, Eliran Yaakobi, Marina Nodelman, Ohad Ronen
TSH routine testing in hospitalized patients has low efficacy, but may be beneficial in a selected subgroup of patients. Our aim was to evaluate the efficacy of routine thyroid function tests among patients admitted to internal medicine departments. A retrospective study. A randomly selected cohort of hospitalized patients with abnormal TSH (thyroid stimulating hormone) blood tests drawn as part of admission protocol. Patient data was collected from the electronic medical files and analyzed for its efficacy...
March 23, 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29569174/relationship-between-organizational-culture-and-the-use-of-psychotropic-medicines-in-nursing-homes-a-systematic-integrative-review
#19
REVIEW
Mouna Sawan, Yun-Hee Jeon, Timothy F Chen
BACKGROUND: Psychotropic medicines are commonly used in nursing homes, despite marginal clinical benefits and association with harm in the elderly. Organizational culture is proposed as a factor explaining the high-level use of psychotropic medicines. Schein describes three levels of culture: artifacts, espoused values, and basic assumptions. OBJECTIVE: This integrative review aimed to investigate the facets and role of organizational culture in the use of psychotropic medicines in nursing homes...
March 22, 2018: Drugs & Aging
https://www.readbyqxmd.com/read/29566917/therapeutic-challenges-in-the-mature-patient
#20
Zrinka Bukvić Mokos, Anamaria Jović, Romana Čeović, Krešimir Kostović, Ivica Mokos, Branka Marinović
With the tremendous increase in the proportion of seniors in the global population, geriatric health care has become of greater interest and concern. Increased emphasis on geriatric medicine, along with the growth in the development of age-related skin disorders, has led to particular attention for geriatric, dermatology and dermatopharmacology. An aging population has brought many therapeutic challenges that we need to recognize and overcome by applying geropharmacologic principles. The purpose of this paper is to inform dermatologists of the age-related changes in the pharmacokinetics of common dermatologic drugs, their various interactions potentially occurring in the elderly, and the principles and evidence-based strategies for detection, management, and prevention to improve medication adherence...
March 2018: Clinics in Dermatology
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